ObjectiveTo explore the best treatment method for patients with pancreatic cancer by analyzing the clinical and survival features.MethodsThe clinical data of 74 patients with pancreatic cancer diagnosed by pathology diagnosis(surgical pathology or biopsy) or clinical diagnosis(imaging + tumor marker CA19-9) were collected.The cases were divided into 5 groups according to different therapy methods:surgery alone group(11 cases),postoperative chemotherapy group(20 cases),palliative chemotherapy group ( 13 cases),palliative radiotherapy group ( 13 cases),untreated group ( 17 cases).The clinical features and overall survival time of patients with pancreatic cancer were analyzed.ResultsThe median overall survival time of postoperative chemotherapy group was longer than that of untreated group (300 d vs.119 d,P ＜ 0.01 ) ; The median overall survival time of surgery alone group,palliative chemotherapy and palliative radiotherapy group had no significant difference compared with that of untreated group (120,164,109 d vs.119 d,P＞ 0.05 ).The patients with advanced pancreatic cancer often suffered from abdominal pain,jaundice,nausea,vomiting,weight loss and other associated symptoms.The incidence of jaundice of patients undergoing surgery was lower compared with non-surgical patients,but the difference was not significant [ 19.35％ (6/31 ) vs.37.21％ (16/43),X2 =2.75,P =0.10 ].The incidence of abdominal pain of patients with radiotherapy was lower than that of non-radiotherapy patients[ 23.08％ (3/13) vs.68.85％(42/61 ),x2 =12.59,P =0.00 ].The ascites incidence rate was 75.68％ (56/74) which shortened the overall survival time,and untreated group had the highest risk rate of ascites.ConclusionsOperation combined with chemotherapy is a better treatment that can improve the overall survival time of patients with pancreatic cancer.Radiotherapy can obviously relieve the abdominal pain.Ascites is a signal of poor prognosis during the treatment process.

Objective To investigate the distribution and drug resistance of common pathogens in Xinjiang ,aare so as to provide references for reasonable use of antibiotics .Methods The strains of common pathogens isolated from patients in the First Teaching Hospital of Xingjiang Medical University from 2012 to 2013 were collected ,and the drug susceptibility testing were performed by K‐B methods recommended by CLSI .Results Totally 18 374 strains were isolated ,among them 13 323 strains were gram negative and 5 051 strains were gram positive .Escherichia coli ,Klebsiella pneumoniae ,Staphylococcus aureus ,Acinetobacter baumannii and Pseudomonas aeruginosa occupied the top 5 .Most of strains were isolated from sputum (accounted for 36 .1% ) .Escherichia coli and Klebsiella pneumoniae showed high resistance rate to cefazolin sodium ,cefotaxime and quinolones .The detection rate of ESBLs pro‐ducing Escherichia coli and Klebsiella pneumoniae were 48 .4% and 41 .7% ,respectively .The resistance rate of Pseudomonas aerug‐inosa to commonly used antibiotics was 10 .0% ~20 .0% .Methicillin resistant staphylococcus aureus(MRSA) accounted for 44 .7%of all Staphylococcus aureus ,and no strains of Staphylococcus resistant to vancomycin ,teicoplanin and Linezolid were found .Conclu‐sion Gram negative bacteria are the most common strains isolated from clinical in this area ,and strains are mainly isolated from samples of respiratory tract and genitourinary tract ,and the situation of drug resistance is severe ,which indicate the clinicians should strengthen the monitoring of drug‐resistant bacteria and promote rational use of antimicrobial agents .

Objective To amplify the higA gene from the Mycobacterium tuberculosis,and to analyze the structure and function of their encoded proteins by using bioinformatics.Methods Total DNA was extracted from Mycobacterium tuberculosis.PCR of higA was performed and the products were sequenced.The biological features of the higA protein including,its physical and chemical properties,signal peptide,spatial structure and epitopes were analyzed by using software online.Results The PCR products of higA were 450 bp in length,which were consistent with the expected size.The higA protein consisted of 149 amino acids and had the following characteristics:a theoretical isoelectric point of 7.93,a fat-soluble factor of 94.30,and instability coefficient of 36.57.The higA protein had no signal peptide,containing 10 phosphorylation sites and multiple potential epitopes.Conclusion Mycobacterium tuberculosis higA gene can be amplified by PCR and the characteristics of higA protein is identified.

Objective To investigate the score changes of graduates majoring in clinical medicine after using the method of “role of identification”. Methods Sixty students who were undertaking internship in Endocrinology Department of Shanghai Traditional Chinese Medicine Hospital received three-week clinical teaching and examination. Then they got into one-week “role of identification”, and were appointed as clinical teachers to teach what they have learned during the last 3 weeks to the next batch of interns and make another examination. Scores of the two examinations were compared. Results Scores of the examination after received the method in“role of identification”improved significantly (P<0.01). Conclusion The method of“role of identification”can enhance clinical medicine graduates’ mastery of professional knowledge.

Objective To evaluate the role of C-Jun N-terminal kinase (JNK) signal transduction pathway in spinal neurotoxicity induced by lidocaine in rats.Methods Seventy-two adult male Sprague-Dawley rats,weighing 220-260 g,were randomly divided into 6 groups (n =12 each):control group (group Ⅰ),sham operation group (group Ⅱ),JNK inhibitor group (group Ⅲ),dimethyl sulfoxide (DMSO) group (group Ⅳ),lidocaine group (group Ⅴ),and JNK inhibitor and lidocaine group (group Ⅵ).Group Ⅰ received no treatment.Intrathecal catheter was placed in the subarachnoid space in group Ⅱ.SP600125 25 μg and DMSO 20 μl were injected intrathecally in Ⅲ and Ⅳ groups,respectively.In group Ⅴ,10％ lidocaine 20 μl was intrathecally injected.SP600125 25 μg was injected intrathecally and 30 min later 10％ lidocaine 20 μl was injected intrathecally in group Ⅵ.Paw withdrawal threshold to yon Frey filament stimulation (PWT) and paw withdrawal latency to nociceptive thermal stimulation (PWL) were measured before intrathecal catheter was implanted (T0),before intrathecal administration (T1) and at 4,8 and 12 h and on 1,2,3,4,5 and 6 days after intrathecal administration (T2-10).At 24 h after intrathecal administration,4 rats were randomly chosen from each group and sacrificed.Their lumbar enlargements were removed for determination of phosphorylated JNK (p-JNK) expression (using Western blot) and neuronal apoptosis (by TUNEL).The apoptotic index was calculated.Results Compared with group Ⅰ,no significant difference was found in MWT and TWL in Ⅱ,Ⅲ groups and expression of p-JNK in Ⅱ and Ⅳ groups (P ＞ 0.05),MWT at T2-4,6-8 and TWL at T2-4,7 in group Ⅴ and MWT at T2-6 and TWL at T2-5 in group Ⅵ were significantly increased,the expression of p-JNK was down-regulated and the apoptotic index was decreased in group Ⅲ (P ＜ 0.05),and the expression of p-JNK was up-regulated and the apoptotic index was increased in Ⅴ and Ⅵ groups (P ＜ 0.05).Compared with group Ⅴ,MWT and TWL were significantly decreased,the expression of pJNK was down-regulated and the apoptotic index was decreased in group Ⅵ (P ＜ 0.05).Conclusion Activation of JNK signal transduction pathway is involved in spinal neurotoxicity induced by lidocaine in rats possibly through promoting neuronal apoptosis in the spinal cord.

Objective To investigate the effect of fluorescence in situ hybridization (FISH) in increasing the accuracy and detection rate of chromosome aneuploid from spontaneous abortion specimens.Methods Chromosome 13,21,16 and 22 single sequence probes and centromere probes of 18,X and Y chromosome probes were used to detect 100 cases of spontaneous abortion villi samples.The results were compared with conventional karyotype analysis.Results (1) Karyotype analysis:Among 89 successfully cultured villi samples,51 abnormal karyotypes (57.3％) were found,including 37 cases of autosomal aneuploidies,four sex chromosome aneuploidies,two triploids,one tetraploid,one 68,XX and six chromosome structural aberrations.(2) FISH:The detection rate of abnormal karyotype was 38.0％ (38/100),among which 25 cases were autosomal aneuploidies,five sex chromosome aneuploidies,three triploids,four XX chimeras and one triploid in chromosome 13,16,18 and 21.(3) Comparison of the two methods:Among the 11 samples which failed by conventional method,FISH found two abnormal samples.In specimens of 46,XY,three cases showed mosaicism by FISH.In specimens of 46,XX,two cases showed chromosomal abnormalities by FISH.FISH detected overall 65.5％ (38/58) of the chromosomal abnormalities.Conclusions FISH combined with conventional chromosome analysis could improve the accuracy and detection rate of abnormal karyotypes in spontaneous abortion specimens.

Objective:To investigate the clinic effect of r-MHT and hematoma aspiration on the traumatic intracerebral hematoma.Methods:89 cases with traumatic intracerebral hematoma were given hematoma aspiration,47 of them were given r-MHT and hematoma aspiration,the clinic effect on the 1st,7th,14th day after treatment were evaluated by NIHSS,the hematoma volume before treatment on the 1st,7th,14th day after treatment were counted by Dotian formula.Results:The effective rate of treatment group was 93.6％,which was significantly higher than that of the control group (P＜0.05).The NIHSS score of treatment group was significantly higher than that of the control group(P＜0.05) on the 1 st day,1st,2nd week after treatment (P＜0.05).Conclusion:r-MHT and hematoma aspiration couldn effectively reduce the brain damage,improve the patient's neurological fumction in treating traumatic intracerebral hematoma.

AlM:To explore the primary culture conditions for four kinds of lens epithelial cells ( LECs) of rat, rabbit, dog, and human, and measure their growth characteristics.METHODS:The lens capsule or anterior capsular tissue of rat, rabbit, dog and patient were removed by different methods, and they were cut into tiny pieces for primary culture by modified tissue adherent method. The morphological features of four kinds of LECs were observed under an inverted microscope.RESULTS: Four kinds of LECs of rat, rabbit, dog and human could be cultured primarily by tissue adherent method. With the evolution of tissue source, the adherent capacity of LECs gradually strengthened, cells form were changed from irregular polygon to oval, nucleus rounded and cytoplasm enriched gradually. Four kinds of LECs had fibrotic changes after several passages.CONCLUSlON: LECs of rat, rabbit, dog and human can be primarily cultured. This method lays the foundation for the mechanism research of caratact and related fields on the cellular and molecular levels.

Objective:To examine the infection of the enterovirus and human herpes virus in children with suspected encephalitis.Methods:A total number of 365 suspected encephalitis cases were included in this study from August 2017 to December 2019 in Hunan Children′s Hospital. The clinical samples, the cerebrospinal fluid (CSF), serum, sputum, stool and urine were collected and preserved at-80 ℃condition. The enterovirus (EV) and human herpesvirus (HHV) were examined by a one-step nested reverse transcription PCR(RT-PCR) and a real-time fluorescent quantitative PCR (qPCR), respectively. The positive rate of the two viruses in clinical specimens of children with suspected encephalitis was examined. Among all cases, 132 cases were diagnosed with EV encephalitis or HHV encephalitis.Results:the EV encephalitis were identified in 20.5% (75/365) children with suspected viral encephalitis; whereas HHV encephalitis infection was identified as 15.6% (57/365). Among the 75 cases of EV encephalitis, echo 6 was the main sub-type of these diseases 52.0% (39/75) and others were EV71 (30.7%, 23/75), echo11 (6.7%, 5/75), Coxsackie virus A group 6(CA6, 4.0%, 3/75), echo30 (1.3%, 1/75), echo9 (1.3%, 1/75), echo4 (1.3%, 1/75),Coxsackie virus B group 1(CB1, 1.3%, 1/75))and poliovirus(1.3%, 1/75).Human herpes virus type 6 (HHV6) was the most common pathogen in 57 cases of HHV encephalitis, accounting for 35.1% (20/57).The other pathogens were Cytomegalovirus (CMV, 31.6%, 18/57), Epstein-Barr virus (8.8%, 7/57), Herpes simplex virus 1 (HSV1, 10.5%, 6/57), HSV2 (8.8%, 5/57), and Varicella zoster virus (VZV, 1.8%, 1/57) .The virus in CSF detected significantly earlier than that in serum after onset. Virus could be detected in CSF 2-7 days after onset,but 7-26 days in serum. Conclusions:This study uses nested PCR and qPCR to detect pathogens in clinical specimens of children. This not only expands our understanding of the clinical examination and diagnosis of viral encephalitis in children, but also promotes the method of this study to benefit more children.

Objective To assess the face and construct validity of a full procedural transurethral prostate resection simulator (TURPSimTM) in the training of transurethral resection of the prostate. Methods Ten experienced and thirteen inexperienced urologists (TURP experience ≥ 30 and ≤ 3 respectively) were included for TURP training on TURPSimTM. Each participant filled out a questionnaire regarding their previous experience and opinion of the usefulness of the simulator before and after performing six full procedures at level-2 difficulty. Performance was evaluated between the two groups and pre- /post-training, including GRS and objective parameters recorded on the simulator. Results The experienced group had higher GRS scores (16.3±2.6 vs 12.9±4.0, P=0.024) and prostate resection rate [(94.6±2.8)% vs (89.8±4.4)%, P=0.006]. Less blood loss [(78 ml vs 115 ml, P=0.208) and less capsule resection rate [(27.6±5.4)% vs (29.1±6.2)%, P=0.558] were detected in the experienced group than in the inexperienced group with no significant differences. After training, GRS and coagulation precision increased (14.4±3.8 vs 20.0±3.4, P<0.001; 93% vs 100%, P=0.001) ,while capsule resection rate [(28.4±5.8)% vs (20.8±3.9)%, P<0.001), blood loss (86 ml vs 76 ml, P=0.039) and injury of sphincter (5.5±2.2 vs 3.2±1.7, P<0.001) decreased in both groups. Conclusions Proof of face and construct validity is shown for this full procedural simulator to simulate the skills necessary to perform TURP. The surgical skills of urologists may be enhanced after training on the simulator.