Objective To study the effect of bacillus licheniformis and live combined bifidobacterium and lactobacillus on chemotherapy-induced diarrhea (CID). Methods Seventy-two gastric cancer patients with CID were collected and the clinical data were analyzed retrospectively. The patients were divided into 4 groups according to different treatment methods with 18 cases each. The patients in group A were treated with montmorillonite powder, the patients in group B were treated with montmorillonite powder and bacillus licheniformis, the patients in group C were treated with montmorillonite powder and live combined bifidobacterium and lactobacillus, and the patients in group D were treated with montmorillonite powder, bacillus licheniformis capsule and live combined bifidobacterium and lactobacillus. The patients with severe diarrhea in 4 groups were treated with rehydration, maintaining water and electrolyte balance and nutritional support. The Karnofsky performance scale score (KPS score), diarrhea grading before and after treatment and treatment effect were recorded. Results The KPS score after treatment in group A, group B, group C and group D were significantly higher than that before treatment: (70.6 ± 10.6) scores vs. (62.2 ± 12.2) scores, (76.1 ± 7.8) scores vs. (61.7 ± 9.9) scores, (77.2 ± 7.5) scores vs. (61.1 ± 10.8) scores, (83.9 ± 5.0) scores vs. (63.9 ± 10.9) scores. Moreover, The KPS score in group B, group C and group D were significantly higher than that in group A, the KPS score in group D was significantly higher than that in group B and group C, and there were statistical differences (P<0.05). The diarrhea grading after treatment in 4 groups were improved compared with that before treatment. Furthermore, the diarrhea grading in group B, group C and group D were significantly better than that in group B and group C, and there were statistical differences (P<0.05). In group A, there were 2 cases with excellent effect, 10 cases with effect and 6 cases with no effect;in group B, there were 8 cases with excellent effect, 8 cases with effect and 2 cases with no effect;in group C, there were 7 cases with excellent effect, 9 cases with effect and 2 cases with no effect; in group D, there were 9 cases with excellent effect, 9 cases with effect and 0 case with no effect. The treatment effect in group D was significantly better than that in the other 3 groups, and there were statistical differences (Hc = 10.81, P<0.05). Conclusions Bacillus licheniformis and live combined bifidobacterium and lactobacillus is more effective in the treatment of gastric cancer patients with CID.

BACKGROUND: Mesenchymal stem cells (MSCs) have the abilities of self-renewal, multidirectional differentiation and immunomodulation, and have become the focus of current research. OBJECTIVE: To summarize the immunomodulation of MSCs to different immune cells and the clinical applications of MSCs in the treatment of immune-related diseases. METHODS: The first author searched the PubMed and the CKNI databases for relative articles from January 1974 to December 2016. The key words were mesenchymal stem cells, immunomodulation, MSC1 and MSC2, autoimmune diseases in English and Chinese, respectively. Finally, 52 representative articles were included. RESULTS AND CONCLUSION: MSCs can inhibit the function of T lymphocytes, reduce the activation, proliferation and antibody secretion of B lymphocytes, affect the polarization of macrophages, inhibit the maturation of dendritic cells, inhibit the proliferation and toxicity of NK cells, so MSCs have the great potential in the treatment of immune-related diseases. However, MSCs exhibit the opposite immunomodulatory abilities under different inflammatory microenvironments, and moreover the definite and controllable mechanism of this phenomenon is still unclear, Therefore, future investigations may focus on the specific mechanism of MSCs in the clinical treatment of immune-related diseases.

OBJECTIVE:To investigate the current situation of unreasonable prescriptions in outpatient and emergency depart-ments of our hospital,and to provide reference for rational drug use in the clinic. METHODS:The evaluation of outpatient and emergency prescriptions in our hospital during 2013-2015 were summarized and analyzed. Irrational prescriptions were divided into 3 categories,involving 19 items. The main,secondary and general factors of irrational prescriptions were analyzed by Pareto chart. RESULTS:Among 19 types of irrational prescriptions,main factors included unsuitable drug selection,inappropriate usage and dosage,inappropriate drug combination,prescribing not in accordance with the antibiotics management regulations,incomplete di-agnosis. No indications of medication,drug dosage beyond the regulations ofthree urgent seven slowwere treated as the second-ary factors. Other 12 items were general factors. CONCLUSIONS:According to the main and secondary irrational drug use types, clinical pharmacists should carry out effective intervention and pharmaceutical care to improve the level of rational drug use and en-sure the safety of clinical drug use.

Sudden sensorineural hearing loss (SSHL),which is a common and frequently encountered disease,is considered to be a medical emergency in otolaryngology.The prevalence of SSHL is increasing in China.The pathogenesis of SSHL is not clear yet.Microcirculatory disorder of inner ear is considered as one of the most important causes of SSHL.In recent years,several reports have found the levels of serum lipids were changed in patients affected by SSHL.The relationship between SSHL and serum lipids was reviewed to provide new ideas for the diagnosis and treatment of SSHL.

Objective To observe the effects of acute normovolemic hemodilution(ANH) plus tranexamic acid on blood loss and blood transfusion in patients with total knee replacement.Methods 98 cases of patients with total knee replacement were divided into ANH group and combination group by computer randomization,49 cases in each group.ANH was performed in ANH group,and ANH plus tranexamic acid was given in combination group.The changes of hemoglobin(Hb),red blood cells deposited(Hct),platelet count(PLT) were observed before and after autologous blood transfusion in two group.The changes of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer were observed at preoperative and postoperative in two group.The amount of blood loss and allogeneic blood infusion,the urine volume and the postoperative flow volume were recorded in two groups.Results The average levels of Hb,Hct after autologous blood transfusion in combination group were higher than those in ANH group,the differences were statistically significant(P<0.05).The average level of D-dimer at postoperative in combination group were higher than that in ANH group,the difference was statistically significant(P<0.05).The amounts of blood loss and allogeneic blood infusion,the postoperative flow volume were lower than those in ANH group,the differences were statistically significant(P<0.05).Conclusion The joint application of ANH and tranexamic acid can effectively reduce the amounts of blood loss and allogeneic blood infusion in patients with total knee replacement,and has a certain clinical value.

Objective To investigate the feasibility of using optical coherence tomography (OCT)in thy-roid surgery .Methods Surgical specimen including parathyroid gland , lymph nodes , adipose tissue and thyroid tissue from patients receiving thyroid surgery in Tianjin Medical University Cancer Institute and Hospital were col -lected.OCT images were collected and the results were compared with the routine examination .Results Para-thyroid glands , lymph nodes , adipose tissue , and thyroid tissue can be obtained high-resolution OCT images .Dif-ferent tissues and metastatic lymph node can be clearly distinguished .OCT imaging took about 1 minute and fro-zen examination cost about 25 minutes.Conclusions OCT is a time-saving, non-invasive and cross-sectional imaging technique .It can obtain clear structural images of the internal microstructure of bio-tissues.OCT technol-ogy used in thyroid surgery including parathyroid identification and determination of lymph node metastasis is fea -sible.

Objective To track superparamagnetic iron oxide (SPIO)-labeled pancreatic islet cells in rats using 3.0T magnetic resonance imaging (MRI), and to detect the survival and rejection of grafts after transplantation. Methods Twenty male Wistar rats and 5 male Lewis rats were included in the study. SPIO-labeled pancreatic islet cells were tracked using a GE 3.0T Signa Excite MRI scanner with an animal coil. The images of SPIO-labeled islet cells in rats after transplantation were compared with those of the unlabeled ones. FSE T2WI sequence and GRE T2*WI sequence were used for the detection. The sensitivity of images for detection of grafts was also compared. SPIO-labeled pancreatic islet cells isolated from Wistar and Lewis rats were transplanted into the liver of Wistar rats. Afterwards, the survival and rejection of islet cells were observed sequentially in these two growps. The rats in the syngeneic group were sacrificed 3 months post-transplantation, while the rats in the allogeneic group were sacrificed 3 weeks post-transplantation. MRI of the grafts were correlated with the pathological results. Results SPIO-labeled pancreatic islet cells were seen on MRI as distinct homogenous, hypointense spots in the liver. GRE T2*WI were more sensitive to the detection of SPIO-labeled islet cells than FSE T2WI. The relative count of hypointense spots in the syngeneic group were (90.03±9.52)%, (92.87±18.21)% and (86.25±24.81)%, respectively at 1 week, 2 weeks and 3 weeks after transplantation, while the relative count in the allogeneic group were (41.40±15.41)%, (33.41±14.01)% and (23.58±16.78)%, respectively. The difference between these counts was statistically significant (P<0.01). Iron particles were detected only in the SPIO-labeled cells. Three months post-transplantation, the grafts were found well-preserved in the liver of the rats of the syngeneic group, while only a few grafts were found in that of the allogeneic group. Conclusions MRI can be used to track SPIO-labeled islet cells in vivo, and has significant value in detecting the survival and rejection of grafts after transplantation in rats.

Objective To explore the protective mechanisms of Buyanghuanwu decoction (BHD) on heart function by observing its effect on MIRI rabbits. Methods The rabbits were randomly divided into three groups, including sham group, model group, and BHD group. After pretreatment for one week, the model of myocardial ischemia reperfusion injury was established by ligating the branch of left coronary arter-y. The changes of electrocardiography were observed, and the values of LVSP, + dp/dtmax, - dp/dtmax were recorded and compared. Results Compared with the model group, the values of LVSP, + dp/dtmax, - dp/dtmax in BHD group were significantly increased (P<0.01 ). Conclusion BHD can improve heart function of MIRI rabbits.

Objective To evaluate the sensitivity and specificity of prenatal ultrasound for detecting fetal cleft lip and palate,and the diagnosis rate of associated congenital structural and chromosomal abnormalities.Methods Thirty one thousand two hundred and forty five singleton pregnant women accepted prenatal examination and delivered in Guangzhou Women & Children' s Medical Center from Jan.2006 to Dec.2010 were recruited in this study.All pregnant women underwent prenatal ultrasound screening during second trimester,and whose fetuses were suspected to be cleft lip and palate were suggested to accept karyotype analysis.All babies delivered received oral examination to diagnose cleft lip and palate.Results Cleft lip and palate was diagnosed in 48 cases (1.5‰,48/31 245).Among which,there were 16 cases (33.3％,16/48) of cleft lip,21 cases (43.8％,21/48) of cleft lip with cleft palate and 11 cases (22.9％,11/48) of cleft palate.Prenatal ultrasound screening suggested 18 cases of cleft lip and 14 cases were comfirmed after birth with the accuracy rate of 77.8％,3 cases were diagnosed to be cleft lip with cleft palate and one cases was misdiagnosed.Prenatal ultrasound screening suggested 18 cases of cleft lip with cleft palate in accordance with the diagnosis after birth.Thirteen cases were normal in prenatal ultrasound screening,but two were diagnosed as cleft lip and 11 were diagnosed as cleft palate after birth.The sensitivity of prenatal ultrasound screening for cleft lip and cleft lip with cleft palate was 86.5％(32/37),and the sensitivity for cleft lip and palate was 66.7％ (32/48),the false positive rate was 2.1％ (1/48).Ten cases (27.8％,10/36) of cleft lip with cleft palate were found to be complicated with other abnormalities.Nine of the 18 cases prenatally diagnosed cleft lip with cleft palate accepted karyotype analysis and 7 were abnormal.Twenty-three of 36 cases with fetal cleft lip and palate in prenatal ultrasound screening were induced.Conclusions Ultrasound screening has a high sensitivity for detection of cleft lip with or without cleft palate,but difficult to detect cleft palate.The risk of combining with chromosomal defects in cleft lip fetus is very low,but might increase once associated with cleft palate.

Objective To investigate the protective effect of somatostatin (SS)combined with growth hormone (GH) in treatment of intestinal mucosal barrier injury in rabbits with severe acute pancreatitis (SAP), as well as its clinical significance. Methods Seventy-two rabbits were equally assigned into model group (SAP group), SS treated group (SS group) and SS combined with GH treated group (SS + GH group). SAP models were induced by retro-injection of 5% sodium taurocholate into the pancreatic duct. After modeling, all rabbits were given 5 % glucose saline daily.The rabbits in SS group and SS+GH group were continuously Given SS (3.5μg·kg-1·h-1)for 48 hours. Besides, the rabbits in SS+GH group were subcutaneously injected with 0.15 IU/kg of GH at the 1st and the 24th hours after modeling. The levels of serum amylase, serum tumor necrosis factor-α (TNF-α) and plasma diamine oxidase were measured at the 6th, 12th, 24th and 48th hours after modeling. The pathological changes of pancreatic tissue and ileal mucosa were observed. Survival rate was calculated. Data were analyzed using SPSS 16.0 software. The univariate analysis was used to compare the difference among groups. Results In SS+GH group, the levels of serum TNF-α and plasma diamine oxidase were (2. 43 ± 0. 14) pg/ml and (4. 61 ± 0. 45) U/L at the 24th hour respectively, and were (2.08±0.23) pg/ml and (3.75±0.47) U/L at the 48th hour, respectively,which were lower than those in SAP group and SS group [(2.80 0.30) pg/ml and (8.74 ± 1.77)U/L, respectively, at the 24th hour; (2. 45±0.12) pg/ml and (5. 02±0.95) U/L, respectively, at the 48th hour)]with significant difference (P＜0.05). The inflammation in pancreas and ileal mucosa was alleviated, and the integrity of bowel mucosa was improved. Survival rate of SS+GH group was significantly higher than SAP group and SS group. There was no significant difference in level of serum amylase between SS+GH group and SS group. Conclusion The combination of SS with GH may enhance the function of intestinal mucosa barrier and improve the prognosis of SAP in rabbits.