Objective To compare T and N staging of esophageal and cardia cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) before operation, and to evaluate clinical value of EUS.Methods Twenty-eight patients received examination of EUS and CT preoperatively, and the T and N staging was determined. The accuracy rates of both T, N staging were compared by the postoperative pathological results, at the same time, the accuracy rates of lymph node metastasis were compared, and the value of application of EUS was investigated. Results In the twenty-eight cases, the accuracy rates of EUS were higher than that of CT by 89.3% ( 25/28 ) to 46.4% ( 13/28 ) in T staging. And the difference had statistical significance( P = 0. 004 ,P ＜ 0.01 ). The N stagings of both were 82.1% (23/28) and 50.0% ( 14/28), and the difference had statistical significance ( P = 0. 035, P ＜ 0. 05 ). The accuracy rates of lymph node metastasis of both were 88.7% and 72.2% respectively, and the difference had statistical significance (χ2 = 7.031,P = 0.008, P ＜ 0. 01 ). Conclusions EUS has very important value in preoperative staging for esophageal cancer and cardia cancer, and the T staging of EUS is better than that of CT. The short axis and the ratio of short to long axis (S/L) combined with the lymph node ultrasonography image can improve the accuracy rates of lymph node metatsasis and N staging.

Objective:To explore influence of thrombus aspiration combined bivalirudin during emergency PCI on my- ocardial tissue perfusion and clinical prognosis in patients with acute ST elevation myocardial infarction (STEMI). Methods:A total of 102 patients with acute STEMI,who were confirmed with thrombus burden by CAG in our hos- pital from Jan 2012 to Jun 2014,were selected.According to random number table,they were randomly divided into thrombus aspiration + bivalirudin group (n=52,thrombus aspiration group)and heparin group (n=50,routine PCI group).TIMI blood flow grade 3 rate,TIMI myocardial perfusion grade (TMPG)after PCI,ST segment re- gression rate 2h after PCI,peak value and peak time of cTnI after PCI,LVEF,LVEDd,incidence rates of bleeding and major adverse cardiovascular events (MACE)on one week and one month after PCI were compared between two groups.Results:Compared with routine PCI group,there were significant rise in postoperative TMPG grade 3 rate (56.00% vs.88.46%),TIMI grade 3 rate (58.00% vs.88.46%)and ST segment regression rate (52.00% vs. 76.92%)in thrombus aspiration group,P<0.05 or <0.01. Compared with routine PCI group one month after PCI,there was significant rise in LVEF [(53.76±5.24)% vs.(57.95±5.51)%],and significant reductions in LVEDd [(53.70±3.39)mm vs.(50.63±1.24)mm],peak value [(16.00±4.28)μg/L vs.(13.81±4.00)μg/L]and peak time [(14.00±2.80)h vs.(13.00±2.23)h]of cTnI in thrombus aspiration group,P<0.05 or <0.01. Incidence rate of mild bleeding in thrombus aspiration group was significantly lower than that of routine PCI group (1.9% vs.16.0%),P<0.05,but there was no significant difference in incidence rate of MACE between two groups,P>0.05. Conclusion:Thrombus aspiration combined bivalirudin during emergency PCI is safe and fea- sible for acute STEMI patients,it can effectively reduce incidence rate of bleeding,remove coronary thrombus,im- prove myocardial tissue perfusion and doesn't increase incidence rate of MACE.

Objective To compare the separation effects of protein samples extracted by two different methods with two -dimensional gel electrophoresis (2-DE) .Methods Ultrasonic disruption and glass-beads grounding were used to prepare protein samples of Gram-negative bacteria , Gram-positive bacteria and animal tissues .The actual results of the two sample preparation methods were compared by 2-DE.Results The 2-DE maps of samples extracted by the two methods were obtained.Conclusion The 2-DE maps of glass-beads grounding samples are better than those of ultrasonic disruption thanks to their lower backgrounds , which are beneficial for further image analyses .

Objective: To analyze the trend of the fall death rate in Ningbo,and to provide reference for prevention and control of fall death. Methods : The data of fall mortality in Ningbo from 2002 to 2018 was collected to calculate the crude mortality rate,standardized mortality rate,age specific mortality rate and the proportion of fall death types. Joint Point Regression was used to evaluate annual percentage change（APC）of fall mortality. Results : The average annual crude and standardized mortality rate of fall in Ningbo was 16.81/100 000 and 11.18/100 000,showing an upward trend from 2002 to 2018（P<0.05）. The standardized mortality rate of fall was 11.57/100 000 in men and 10.41/100 000 in women,and the difference was statistically significant（P<0.05）,both showing an upward trend from 2002 to 2018（P<0.05）. The standardized mortality rate of fall was 11.07/100 000 in urban residents and 11.25/100 000 in rural residents,and the difference was statistically significant（P<0.05）,both showing an upward trend from 2002 to 2018（P<0.05）. The mortality rate of fall increased with age（P<0.05）. The mortality rate of fall showed a small peak in children less than five years old（1.81/100 000）,and began to rise rapidly in people aged 65 years or over and peaked again in people aged 85 years or over. There were 11 141 cases died of falling on the same plane,accounting for 68.25%. Fall deaths occurred mainly at home,with 11 829 cases（72.46%）. Conclusion The mortality rate of fall in Ningbo increased from 2002 to 2018. The males,urban residents,people aged less than five years and aged 65 years or older have high risk of death from fall,who were targets for prevention and control strategies of fall.

A large number of viruses belonging to Genus Hantavirus in Family Bunyaviridae are etiologic agents for hemorrhagic fever with renal syndrome (HFRS), or hantavirus pulmonary syndrome (HPS). Hantaan (HTN), Seoul (SEO), Belgrade (BEL), Puumala (PUU) serotype viruses are well known causative agents for HFRS in Eurasian continent. Among those viruses Hantaan and Seoul serotypes are well known to cause HFRS in Korea, but there are some sporadic incidence by other than Hantaan or Seoul viruses. Recently we have developed the combined Hantaan-Puumala virus vaccine to prevent world-wide occurring HFRS. This combined vaccine is formalin inactivated, suckling mouse and suckling hamster brain extracts for Hantaan and Puumala viruses, respectively. Protein contents of this purified candidate vaccine is 27 microgram/ml, which contains 1,024 ELISA antigen units to each virus, but content of myelin basic protein which is causing experimental allergic encephalomyelitis is legs than 0.1 ng/ml. Thirty hamsters were given twice at one month interval intra-muscularly and bled on 30 days after each vaccination from retro-orbital sinus vein. Antibody titers were tested against 5 major serotype viruses, Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses by IFA and PRNT. The mean IF antibody titers on 30 days after primary shot were 78.4, 68.8, 68.8, 37.9, and 15.6; mean neutralizing antibody titers were 65.4, 12, 6.1, 65.6 and 0.5 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively. The mean IF antibody titers on 30 days after booster shot were 686.9, 567.5, 550.4, 516.3, and 430.9; and neutralizing antibody titers were 710.8, 41.9, 24.3, 409.9, and 1.6 against Hantaan, Seoul, Belgrade, Puumala and Sin Nombre viruses, respectively.
Animals ; Antibodies, Neutralizing ; Brain ; Bunyaviridae ; Cricetinae* ; Encephalomyelitis, Autoimmune, Experimental ; Enzyme-Linked Immunosorbent Assay ; Formaldehyde ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Incidence ; Korea ; Leg ; Mice ; Myelin Basic Protein ; Puumala virus ; Seoul ; Seoul virus ; Sin Nombre virus ; Vaccination ; Veins

OBJECTIVETo evaluate the efficacy and safety of rituximab in treating patients with refractory and/or relapsing thrombotic thrombocytopenic purpura (TTP).

METHODSTotally three patients received rituximab as salvage therapy in our hospital. Rituximab was administered at a weekly dose of 375 mg/m(2) for 2 or 4 consecutive weeks. After clinical remission, patients were followed up every 3 months.

RESULTSAll three patients achieved complete remission. The median time to platelet count recovery was 7 days (4-12 days) after the first rituximab infusion. During the follow-up (median: 12 months; range: 9-18 months), no patients experienced relapse. No side effect was noted during treatment and follow-up period.

CONCLUSIONTherapy with rituximab is effective and well tolerated for patients with refractory or relapsing TTP.

Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Female ; Humans ; Middle Aged ; Purpura, Thrombotic Thrombocytopenic ; drug therapy ; Retrospective Studies ; Rituximab ; Salvage Therapy ; Treatment Outcome

Objective To evaluate the clinical application value of pathological diagnosis by using ultrasound-guided percutaneous needle core biopsy (PNCB) for cervical lymph lesions.MethodsTwo hundred and ten patients with cervical lymph lesions underwent ultrasound-guided PNCB,and pathological diagnosis were made based on core biopsy material.The results of study were concluded by comparing the pathological diagnosis from core biopsy of the lymph nodes with those from excision biopsy. Results There were 210 patients underwent ultrasound- guided PNCB,98.6％ (207/210) cases of core biopsies yielded adequate material at first time and 92.9％ (195/210) cases of those had pathologic diagnosis.The accuracy of ultrasound-guided PNCB in differentiating benign from malignant lymphadenopathy was 99.4％ ( 194/195 ).The diagnostic accuracy of metastatic tumor and lymphoma by ultrasound-guided PNCB was 96.4％ (135/140) and 86.1％ (31/36),respectively.Only 67.7％ (21/31) patients with lymphoma could be classified by ultrasound-guided PNCB.ConclusionUltrasound-guided PNCB in patients with neck lymph lesions is a safe,convenient and quick procedure that has a high diagnosis accuracy.Ultrasound-guided PNCB can replace the open surgery for neck lymph node diagnostic method.Due to the complicated and diverse pathologic performance,lymphoma should be cut by open surgery to confirm the diagnosis and classification.

Objective To analyze the prognostic value of age in patients with early stage breast cancer. Methods The clinical characteristics of 1030 patients with early stage breast cancer (the number of positive axillary lymph nodes was less than 3) were retrospectively reviewed. Of all the patients, 468(stage Ⅰ, n = 227; and stage Ⅱ , n = 241) received breast conserving surgery (BCS) and 562 (stage Ⅰ, n =184; and stage Ⅱ, n= 378) received modified mastectomy. Patients were divided into young-age group (≤35,136 patients), middle-age group (> 35-≤60,738 patients) and old-age group (> 60,156 patients).The number of patients without postoperative radiation therapy after BCS is 16, 60 and 39 in the three groups, respectively. Two-dimensional conventional fractionated radiotherapy was administered. The prognostic value of the tumor size, status of axillary lymph nodes or hormonal receptors, postoperative radiation therapy were analyzed. Results The follow-up rate was 97.86%. Of 795 patients followed up more than 5 years, 110,569 and 116 patients were devided into the three groups, respectively. There were 40, 202 and 87 patients without radiation therapy in the three groups. The 5-year recurrence rates of the three groups were 6. 2%, 8. 7% and 10. 4% (χ2 = 1.14, P= 0.567). The 5-year distant metastasis rates were4.3% , 9.5 % and2. 5% (χ2 = 5.31 , P = 0. 070) . The5 - year survival rates were9l. 2% , 92. 6%and 82. 1% (χ2 = 6. 83, P = 0.033). The young-age group had more tumors smaller than 2. 0 cm (65.4%), less positive axillary lymph nodes (13.2%), poorer differential tumor and less positive hormone acceptors (48.0%). Of patients with tumor larger than 2. 0 cm who had no radiotherapy after BCS, the 5-year survival rates were 94%, 87% and 71% (χ2= 20.69, P= 0.000) in the three groups. The corresponding recurrence rates were 23%, 18% ,7%, (χ2 = 9. 97, P = 0. 007), and distant metastasis rates were23%, 25% and 10% (χ2 =8.51, P=0. 014). Conclusions The age is an important prognostic factor in patients with early stage breast cancer undergoing BCS, but not in those undergoing modified mastectomy.

OBJECTIVETo search for an effective therapy for regular fever of unclear cause without obviating malaria in Tanzania.

METHODSEighty-one cases of regular fever of unclear cause at 7 pm-6 am. Based on TCM syndrome differentiation, they were treated by injection of Compound Aminopyrine Injection (2 mL), Chaihu Injectio (2 mL) into Dazhui (GV 14), Taodao (GV 13) and Jianshi (PC 5), respectively. Their therapeutic effects were observed.

RESULTSSeventy-six cases were effective, accounting for 93.8%, 3 cases were ineffective, accounting for 3.7%, and 2 cases (2.5%) were unclear because they were unable to be followed up.

CONCLUSIONPoint-injection is an economic, effective and convenient treatment method for regular fever of unclear cause without obviating malaria in the epidemic-stricken area of popular drug dependence for chemical anti-malaria agents.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Fever of Unknown Origin ; therapy ; Humans ; Malaria ; drug therapy ; Male ; Middle Aged

Objective: To observe the efficacy of electroacupuncture (EA) plus Yi Jin Jing (Sinew-transforming Qigong Exercises) for knee osteoarthritis (KOA). Methods: A total of 60 patients with KOA were divided into an observation group and a control group according to the random number table method, with 30 cases in each group. Patients in the observation group received the treatment of EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises), while patients in the control group only received EA treatment. Both groups were treated for 5 weeks. The changes of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores in the two groups were observed after treatment. Results: After treatment, the total effective rate in the observation group (92.3％) was significantly higher than that in the control group (70.0％), (P<0.05); the WOMAC and VAS scores in both groups were significantly lower than those before treatment, showing statistical significance (all P<0.01); there were significant differences in the post-treatment changes in the WOMAC and VAS scores between the two groups (P<0.05, P<0.01). Conclusion: EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises) is clinically effective for KOA. This combined treatment can alleviate clinical symptoms.