Objective To evaluate the efficacy of laparoscopic Miles surgery at differented periods.Methods Radical excision(Miles) was performed under a laparoscope on 33 patients from January 2002 to August 2002(group 1),and then on 34 cases from July 2006 to May 2007(group 2) in our hospital.Clinicopathological and follow-up data of the two groups were collected and analyzed.Results No significant difference was found in blood loss(50-200 ml vs 40-210 ml,Z=1.477,P=0.787),number of resected lymph nodes(both 3-5,Z=-0.089,P=0.233),gas expel(in 1-3 days after the surgery vs 1-4 days,Z=-1.622,P=0.574),and postoperative hospital stay(4-9 days vs 5-9 days,Z=-1.834,P=0.346) between the two groups.However,the patients in group 1 had significantly longer operation time and higher medical cost than group 2(175-210 min vs 120-150 min,Z=4.238,P=0.026;23400-27500 yuan vs 19863-22744 yuan,Z=5.283,P=0.003).Conclusion After 4-year development,the operation time and cost of laparoscopic Miles surgery has been decreased.

OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in ICU,then instruct clinical application of antibiotics reasonably.METHODS The identification of bacteria,isolated from patients in ICU from Jan 2005 to Dec 2006,and antibiotic susceptibility by ATB expression were used.RESULTS A total of 1197 pathogens strains were isolated,Gram-negative bacilli,Gram-postive cocci and fungi accounted for 64.2%,19.6% and 15.8%,respectively.The most common pathogens of them were Pseudomonas aeruginosa(22.1%).Except Escherichia coli(40%),the rate of the ESBL-producing strains of Serratia marcescens,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae were higher than 70%.The most common pathogens of Gram-postive cocci were Staphylococcus.Meticillin-resistant strains of Staphylococcus aureus accounted for 93.8%.Mainly pathogenic bacteria were multi-resistant to some antibiotics.There were 189 strains fungi.And all the fungi were sensitive to amphotericin B,fluconazole and ketoconazole.CONCLUSIONS The infection and multi-drug resistance of pathogens are serious in ICU.It′s important and urgent to carry out surveillance of bacterial resistance for appropriately using antibiotics.

OBJECTIVE To investigate the influence on air quality in cleaning room of the supply department when the water/gas blast gun is used to clean endoscope,to give basis for valuable protective procedures. METHODS Bacterial number of the air in the supply department was sampled using flat plate settling process pre-and post-operation. Simultaneously,the air purification effect of the laminar purification equipment was evaluated. RESULTS The air bacterial content before the water/gas blast gun ran was significantly different from that when the gun stopped (P

Background and purpose:The incidence of thyroid cancer (TC) is increasing worldwide. However, there were some differences among different regions. The purpose of this study was to investigate the incidence trends and clinicopathological characteristics of TC in Qingdao, a typical eastern coastal city, and to analyze the change in etiological spectrum of surgical thyroid diseases in recent years.Methods:A total of 2 251 patients who underwent thyroidectomy in 2014 due to thyroid nodules at the Affiliated Hospital of Qingdao University were retrospectively reviewed. The clinico-pathological characteristics were further analyzed among 1 306 patients with TC and compared with the corresponding data from the Surveillance Epidemiology and End Results (SEER) database as well as previous data from this hospital.Results:With the increasing number of thyroidectomy in Qingdao, there was also an increase in the proportion of TC in patients after thyroidectomy, from 34.8% in 2010 to 59.0% in 2014. Among those with TC, the male-to-female ratio was 1∶2.80, with a relatively high incidence among 20-54 year-old adults, who were younger than those reported in terms of distribution of age in SEER database (U=2 289,P=0.000). About 50.2% of the TC patients were overweight or obese, 78.2% TC patients had only asymptomatic nodules detected by ultrasound at initial diagnosis, while 16.6% had visible or palpable thyroid nodules. Only 5.2% presented hoarseness or other repression symptoms. Micro-carcinoma accounted for 61.7% of TC in 2014 at this hospital, which was significantly higher than the proportion in 2010 (37.7%). Lymph node involvement was significantly more frequent at this hospital than in SEER database (49.5%vs 26.0%,χ2=11.806,P=0.001). Even among patients with micro-carcinoma, 31.3% already presented lymph node metastases. The proportions of papillary, follicular, medullary and anaplastic carcinoma were 97.5%, 1.1%, 1.0% and 0.5%, respectively, among which the percentage of papillary carcinoma was higher than that in SEER database (U=4 654.5,P=0.055).Conclusion:There was an increase in the number of thyroidectomy in Qingdao, and the preoperative diagnostic accuracy of TC in this area kept rising. The in-cidence of TC was relatively high in a younger population, with more common lymph node involvements and an overweight trend. The increasing proportion of micro-carcinoma might be related to the popularization of health examination. However, the frequent lymph node metastasis in patients with micro-carcinoma is an important indicator of the invasive behavior of micro-carcinoma, which should not be overlooked.

OBJECTIVE To synthesize[3H]labelled trantinterol and determine the mass balance in rats and the profile of trantinterol and its metabolites in excreta. METHODS [3H]Trantinterol was synthesised from the intermediate1-(4-amino-3-chloro-5-trifluoromethyl-phenyl)-2-bromo-ethanone through reduction by sodium borotritide and aminolysis by t-butylamine. Following an oral dose of[3H] trantinterol(45.5 MBq·kg-1)to bile duct cannulated(BDC)rats and normal rats. Bile,urine and faeces were collected individually before and after dosing at different times. Liquid scintillation counter(LSC) was used to detect total radioactivity recovery and HPLC/radio-detector for metabolite profiling in urine and bile. RESULTS The majority(73.6%)of the administered radioactivity was recovered in the first 24 h postdose with 48.3%in urine and 25.4%in faeces. It was cumulated to(84.7±6.8)%till 168 h. In BDC rats,29.3%of the dose was recovered in the bile 3 d post-dose. According to the peak area ratio determined by HPLC/radio-detector,only 4.7%and 9.5%of the radioactive dose were excreted as the parent drug in urine and bile,respectively,while the majority of the remaining radioactivity was excreted in the form of various metabolites. CONCLUSION Following oral administration in rats,trantinterol is completely absorbed,extensively metabolized and rapidly excreted mainly in urine as various metabolites.

0.05),but the level of P- selectin in treatment group were obviously decreased compared with control group after the seventh and fourteenth day(P

Objective To purify Shiga toxin Ⅱ (STX Ⅱ) of enterohaemorrhagic Escherichia coli (EHEC) O157: H7 by affinity chromatography, and characterize its biological function. Methods The immno-affinity chromatography column was prepared by STX Ⅱ A subunit-specific antibody S1D8 coupling to Sepharose 4B matrix. The purity and specificity of STX Ⅱ molecule secreted by EHEC O157:H7 were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot, respectively. The purified toxin was serially diluted and the toxic activities to Vero cell line and mice were observed. The 50% cytotoxic dose (CD50) for Vero cell line and 100% lethal dose (LD100) for mice were calculated. The protection effect of anti-STX Ⅱ polysera to the mice against the purified toxin challenge was also observed. Results STX Ⅱ was successfully purified from culture supernatant of EHEC O157:H7 using affinity chromatography scheme. The relative molecular weights of STX Ⅱ A and B subunits were 32 000 and 7 500 confirmed by SDS-PAGE, respectively. The purified toxin could react with monoclonal antibodies against STX Ⅱ A and B subunits, respectively.The toxin was cytotoxic to Vero cell with CD50 of 20 ng/L and lethal to mice with LD100 of 5 ng.The toxin could be neutralized by anti-STX Ⅱ polysera in vivo. Conclusion STX Ⅱ is successfully purified and its toxic effects are confirmed in both cell line and mouse model.

OBJECTIVE:To observe clinical efficacy and safety of citalopram in the treatment of depression patients after lung cancer operation. METHODS:114 depression patients after lung cancer operation were selected and randomly divided into observa-tion group and control group (n=57). Control group was given routine treatment as nutrition support and electrolyte balance,but had no anti-depression drugs;observation group was given Citalopram tablet 20 mg orally,qd. Two groups were treated for 6 weeks. Clinical efficacy,HAMD and HAMA scores,each score and total score of SF-36 were observed before and after treatment. The occurrence of ADR was recorded. RESULTS:The total effective rate of observation group was 87.72%,which was significant-ly higher than that that of control group(71.93%),with statistical significance(P<0.05);there was no statistical significance in HAMA score,HAMD score,each score and total score of SF-36 between 2 groups before treatment(P>0.05);HAMA score and HAMD score of 2 groups decreased significantly after treatment,the observation group was lower than the control group;each score and total score of SF-36 increased significantly,the observation group was higher than the control group,with statistical sig-nificance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Citalopram is effective and safe for depression af-ter lung cancer operation,can improve mental state and quality of life.

Objective:To analyze the expression level of malignant biological marker gene in locally advanced low rectal cancer tissues after neoadjuvant chemotherapy with XELOX, so as to provide guidance for clinical treatment.Methods:Based on the established inclusion and exclusion criteria, 104 patients with locally advanced low rectal cancer treated in the Surgery Department of the Affiliate Hospital of Qingdao University from January 2017 to January 2018 were included in the study. Based on the random number table method, they were divided into observation group and control group, with 52 patients in each group. Radical resection was performed in both groups, while radical resection was performed directly in the control group, and neoadjuvant chemotherapy with XELOX plus radical resection was performed in the observation group. The effect of tumor resection in the two groups was compared and analyzed, and the expression levels of tumor markers and malignant biological marker genes in the tumor tissues after surgery were determined. The 3-year postoperative survival rate of the two groups was followed up.Results:The R0 resection rate was 96.15% in the observation group and 80.77% in the control group, with statistically significant difference ( P<0.05). There were no significant differences in the serum levels of cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA) and carbohydrate antigen 50 (CA50) before the operation in the two groups ( P>0.05). One week after the operation, the serum levels of CA19-9, CEA and CA50 in the observation group were significantly lower than those in the control group ( P<0.05). Through detection, the relative mRNA expression levels of PPTG and Smad4 in the postoperative observation group were higher than those in the control group, while the relative mRNA expression levels of Runx3 and APC were lower than those in the control group, with statistically significant difference ( P<0.05). The 3-year follow-up survival rate in the observation group was 90.38%, significantly higher than 78.85% in the control group ( P<0.05). Conclusions:The application of XELOX neoadjuvant chemotherapy in radical resection of locally advanced low rectal cancer has important clinical value in reducing tumor malignancy, improving tumor resection effect and improving survival.

Objective To discuss the experience of surgical treatment for cerebral sparganosis and analyze the factors affecting the removal of live worms.Methods A retrospective analysis was performed on clinical data and treatment experience of 49 patients with cerebral sparganosis,admitted to and accepted surgery in our hospital from January 2001 to December 2017.These patients were divided into two groups according to whether the live worms were removed during the operation,namely live worms removal group and live worms non-removal group;factors affecting the removal of live worms were analyzed.Results A total of 36 live worms were removed from 49 patients,one of them took out two live worms in the same lesion.In 45 patients with seizures before surgery,39 of them had seizure-flee after surgery (Engel grading I).Re-examination MR imaging showed that lesions disappeared and no new lesions were found in the brains of the 39 patients.Another two with original lesion enhancement had shadow disappearance;however,new lesions appeared behind the lesion;one of them was re-operated in the contralateral temporal lobe of the original lesion,and the other one continued follow-up observation.No new hemorrhage lesion,infarction or meningitis after operation was noted in all patients.Statistical analysis showed that there were significant differences in times from lesion discovery to surgery and lesion locations between patients of the live worms removal group and the live worms non-removal group (P＜0.05).Conclusions Surgical treatment of cerebral sparganosis is safe and effective.Surgical treatment should be performed as soon as possible after the lesion is discovered.The times from lesion discovery to operation should be shortened to prevent the displacement of the worms.At the same time,it is necessary to select the specific surgical plan and timing of surgery in combination with lesion location to improve removal rate of live insects and reduce surgical complications.If necessary,surgery can be performed again.