ObjectiveTo evaluate the efficacy and safety of transcatheter arterial chemoembolization combined with argon-helium cryoablation on patients with advanced unresectable primary hepatocellular carcinoma. MethodsTranscatheter arterial chemoembolization was performed in 35 patients with primary hepatocellular carcinoma,then argon-helium cryoablation was done after 2-3 weeks.The second transcatheter arterial chemoembolization treatment was performed 1-2 week after argon-helium cryoablation.The after treatment response was evaluated and the toxicity was observed.RusultsThirty-five patients were evaluated.Complete response was observed in 7 patients,partial response in 21 patients,stable disease in 4 patients and progressive disease in 3 patients. Overall response rate was 80.00 ％(2g/35), and disease control rate was 91.43 ％(32/35). Patients' median PFS was 8.9 months, median OS was 16.3 months. ConclusionThe therapeutic effect of transcatheter arterial chemoembolization combined with argon-helium cryoablation is good in treating advanced unresectable primary hepatocellular carcinoma.

OBJECTIVETo study the antitumor activities of the liposoluble components from caulis Marsdenia tenocissimae and analyze its chemical constituents.

METHODThe supercritical fluid extraction was used to extract the liposoluble components from caulis M. tenocissimae. MIT test was applied to study the anticancer effects of liposoluble components on growth inhibition in human liver cancer line HepG-2 cells, and the chemical constituents were analyzed by gas chromatography/mass spectrometry (GC-MS).

RESULTThe liposoluble components of caulis M. tenocissimae have obvious growth inhibitory action to HepG-2 cells. Twenty-four compounds were identified and their relative contents were determined.

CONCLUSIONThe liposoluble components from caulis M. tenocissimae have antitumor activities, and its pharmacological activity is related to its chemical constituents.

Antineoplastic Agents ; analysis ; chemistry ; pharmacology ; Cell Proliferation ; drug effects ; Gas Chromatography-Mass Spectrometry ; Hep G2 Cells ; Humans ; Lipids ; chemistry ; Marsdenia ; chemistry ; Solubility

OBJECTIVETo study the chemical constitutes of caulis Marsdeniae tenocissimae.

METHOD70% ethanol extracts of caulis M. tenocissimae were isolated and purified by silica gel column chromatography, Sephadex LH-20 chromatography and semi-preparative reversed phase liquid chromatography (RPLC). The compounds were identified on the basis of spectral analysis, including NMR, MS and IR.

RESULTSeven compounds were obtained and identified and their structures were identified as beta-sitosterol (1), condutirol(2), dihydroconduritol(3), betulinic acid(4), lupeol(5), daucosterol(6), 11alpha-O-(2-methylbutyryl)-12beta-O-acetyltenacigeninB(7).

CONCLUSIONCompound 4, 5 were isolated from the genus for the first time.

Apocynaceae ; chemistry ; Plant Extracts ; analysis ; isolation & purification ; Plant Stems ; chemistry

Objective:To investigate the relationship between manganese superoxide dismutase (MnSOD) gene Val16Ala polymorphism and the susceptibility to prostate cancer.Methods:All literatures related to MnSOD gene polymorphism and susceptibility to prostate cancer were retrieved from PubMed, Embase, China Knowledge Network and Wanfang databases. The retrieval time was from the database establishment to September 19, 2018. Literature screening and data extraction were independently done by 2 investigators, and Meta-analysis was performed by using Stata 12.0 software.Results:A total of 17 studies were included in the final analysis, including 7 101 prostate cancer cases and 9 146 healthy controls (people working at hospital and the ordinary people). The results of Meta-analysis showed that MnSOD gene Val16Ala polymorphism was not associated with susceptibility to prostate cancer under the homozygous model ( OR = 1.12, 95% CI 1.02-1.23, P = 0.435), heterozygous model ( OR = 1.14, 95% CI 1.05-1.24, P = 0.765), dominant model ( OR = 1.14, 95% CI 1.05-1.23, P = 0.552) and allele comparison model ( OR = 1.07, 95% CI 1.02-1.12, P = 0.106). Conclusion:There may not be the relationship between MnSOD gene Val16Ala polymorphism and the susceptibility to prostate cancer.

Objective To evaluate the efficacy of the new treatment regimen versus the standardized scheme for the initial treatment of smear-positive tuberculosis in the elderly.Methods A total of 302 elderly patients meeting the inclusion and exclusion criteria were selected from 14 tuberculosis-designated medical institutions in Beijing.The patients received the initial treatment of smear-positive tuberculosis from January 2014 to August 2016 in the combined prospective and retrospective study.All patients were divided into observation group(n=63)receiving treatment with 6L2 HELfx regimen from August 1,2015 to August 31,2016,and control group (n =239) receiving treatment with 6L2HELfx regimen from January 1,2014 to January 31,2015.The nation-unified standard chemotherapy regimen 2RHZE/4RH was used in tuberculosis medical service institutions for all patients.The differences between the two groups were analyzed and compared in the completion of treatment,negative conversion of sputum culture or smear,adverse drug reactions and treatment outcome.Results The completion rate of long-course therapy was significantly higher in the observation group than in control group [90.5％ (57/63) vs.79.5％ (190/239),x2 =4.034,P =0.045].The rate of negative conversion of sputum culture or smear at the end of the 2nd month was higher in the observation group than in control group,but had no significant difference[87.0％ (47/54)vs.81.6％(155/190),x2 =0.879,P=0.349].The incidence of adverse reactions was much lower in observation group than in control group[46.0％ (29/63) vs.65.3％ (156/239),x2 =7.777,P =0.005].The success rate of treatment(cure or completion of long-course therapy)was higher in observation group than in control group [90.5％ (57/63) vs.77.4％ (185/239),x2 =5.350,P =0.021].ConclusioNS As compared with the standard chemotherapy regimen,the L and Lfxcontaining treatment regimen has better effects,higher success rate of treatment and less adverse reactions in elderly patients with the initial treatment of smear-positive tuberculosis.

BACKGROUND:In recent years,with the development of 3D printing,surgical surgery has become personalized and accurate.3D printed guide template technique can realize preoperative planning and intraoperative navigation,making surgery more accurate.In clinical orthopedic surgery for moderate and severe stiff scoliosis,there is still a problem that the accuracy of screw placement is not high,resulting in screw loosening and even nerve complications.There are few studies on 3D printed guide template technique to guide screw placement in surgery for severe stiff scoliosis. OBJECTIVE:To evaluate the clinical effect of the 3D printed guide template technique combined with multiple posterior derotation in the treatment of severe rigid scoliosis. METHODS:The clinical data of six patients with severe scoliosis undergoing 3D printed guide template technique of pedicle screw combined with multiple posterior derotation were retrospectively analyzed.There were 3 males and 3 females,with a mean age of(18.17±3.49)years(range,15-23 years).The changes of parameters related to lateral bending were analyzed at postoperative 2 weeks and 18 months,and the results were obtained by statistical analysis. RESULTS AND CONCLUSION:(1)The operation time was 280-540 minutes(mean 340.83±102.20 minutes).The intraoperative blood loss was 1 000-4 000 mL(mean 2 000.00±1 073.70 mL).The fixed segments were 9-14 vertebral bodies(mean 11.83±1.72),and no screw loosening occurred during the operation.(2)All patients were followed up.At postoperative 2 weeks,the anteroposterior and lateral radiography of the whole spine showed that the cobb angle,the distance between the vertical line of C7 on the coronal plane and the median line of S1,the distance between the vertical line of C7 in the sagittal plane and the posterior edge of S1,apical vertebral translation,thoracic kyphosis,and lumbar lordosis were significantly corrected.The average correction rate of the cobb angle in the main curve was 62.22%.After 18 months of follow-up,there was no significant change in all parameters compared with 2 weeks after operation;the orthopedic effect was satisfactory,and there was no infection or internal fixation fracture.(3)There was one case of delayed wound healing;scar healing appeared after dressing change treatment;no neurological complications occurred.(4)The results show that the 3D print-guide template combined with multiple posterior rod derotation technique is safe and effective in the treatment of severe rigid scoliosis,and the correction effect is satisfactory.

Objective To investigate the bacterial resistance in nationwide and understand the distribution of bacterial and resistance trend.MethodsThe 6507 clinical isolates were collected from 19 hospitals in 17 cities.The susceptibility tests were performed using agar dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The values of MIC50,MIC90 and MICrange were calculated by SPSS 17.0 and the susceptibilities of isolates to antimicrobial agents were determined by using CLSI (2010) guideline.Of all 6507 isolates,4691 strains were collected from target wards and 1816 were isolated from others wards.ResultsAmong 4691 strains,1156 were Gram-positive (24.6％ ) and 3535 were Gram-negative (75.4％).Based on the minimum inhibitory concentration results,the prevalence of methicillin resistant Stapylococcus aureus and methicillin resistant Stapylococcus epidermidis are 51.6％ ( 325/630 ) and 87.0％ ( 228/262 ) respectively.Staphylococci showing intermediate or full resistance to vancomycin were not observed. Coagulase negative Staphylococci showed 2.5％ (16/642)intermediate rate and 1.6％ ( 10/642 ) full resistance rate to teicoplanin,and showed 0.5％ ( 3/642 )resistance rate to linezolid.Antibiotic resistance rate of Enterococcus faecalis to ampicillin was 17.1％(19/111),while the resistance rate of Enterococcus faecium to ampicillin reached up to 85.0％(164/193).Three Enterococcus faecium were resistant to glycopeptides.The prevalence of penicillin resistance Streptococcus pneumoniae and penicillin intermediate Streptococcus pneumoniae were 41.2％ ( 145/352) and 37.2％ (131/352) respectively based on oral penicillin criterion,while the prevalence were 0.0％ (0/352) and 6.0％(21/352) based on vein to non-meningitis criterion.A vast majority of Enterobacteriaceae maintained high susceptibility to carbapenems,with resistance rate less than 2.0％.In addition,tigecycline,moxalactam,fosfomycin and amikacin displayed desirable antibacterial activity against Enterbacteriaceae,and resistance rates to these drugs were all less than 10.0％.For non-fermenting Gramnegative isolates,resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 23.1％ ( 139/601 ) and 53.5％ (419/784) respectively.Resistance rate of Acinetobacter baumannii was much higher than that during the period 2007 - 2008.Colistin,tigecycline,minocycline and fosfomycin demonstrated good antibacterial activity against Acinetobacter baumannii in vitro.Conclusions Compared with MOHNARIN 2007 -2008year surveillance results, significant increase in resistance rate of Acinetobacter baumannii was demonstrated.Resistant strains to linezolid and tigecycline were found.Bacterial resistance has been a widespread problem in our country,which requires much more attention.

OBJECTIVETo observe the effect of electroacupuncture (EA) combined with general anesthesia for the immune function of patients treated with laparoscopic radical rectectomy for rectal cancer.

METHODSFifty patients who would receive selective laparoscopic radical rectectomy for rectal cancer with general anesthesia were randomly divided into an observation group and a control group,25 cases in each one. Fifteen minutes before anesthesia induction,patients in the observation group were treated with EA at Zusanli (ST 36) and Sanyinjiao (SP 6) until the end of operation. Sham acupuncture without piercing the skin was applied at the same acupoints in the control group, and electrodes were connected without stimulation. Interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-6 (IL-6) were quantitatively tested before anesthesia (T), at the time of abdomen closing (T) and one hour after anesthesia anabiosis (T). And serum procalcitonin (PCT) level, leucocyte count and the number of cases with increasing leucocyte (the standard number>10×10/L) were measured on the first day after operation.

RESULTSThe levels of IL-4 and IL-6 were increased apparently and the ratio of IFN-γ/IL-4 was decreased at Tcompared with those before treatment in the control group (all<0.05), but obvious change did not appear in the observation group (all>0.05). The ratio of IFN-γ/IL-4 was enhanced (<0.05),and the levels of IL-4 and IL-6 were reduced (both<0.05) at Tin the observation group compared with those in the control group. The level of PCT of the observation group was markedly lower than that of the control group on the first day after operation (<0.05). There was no statistical significance about leucocyte count and the number of cases with increasing leucocyte between the two groups (both>0.05).

CONCLUSIONSEA at Zusanli (ST 36) and Sanyinjiao (SP 6) could alleviate the depressing immune function and inflammatory reaction of patients after laparoscopic radical rectectomy for rectal cancer.

80% activity rate against E.coli included piperacillin/tazobactam(93.4%)、ceftazidime(86%),and amikacin(83.3%);The susceptible rate to piperacillin/tazobactam in K.pneumoniae was 84.6%. The susceptible rate to ceftazidime decreased from 82.3% to 69.9%, which was lower than to cefepime (77.2%). Over 50% of Enterobacter cloacae were resistant to ceftazidime, cefotaxime and ceftriaxone. Susceptible rates to piperacillin/tazobactam in E. cloacae,E. aerogenes,Citrobacter freundii and Serratia marcescens (67.7%-96.4%) were higher than those to cefepime (68.8%-77.5%), cefoperazone/sulbactam (59.7%-87.5%). Susceptibility to amikacin among these 4 species (70%-83.7%) was higher than to ciprofloxacin (48.1%-79.5%). All of Morganella morganii and Proteus vulgaris isolates were susceptible to meropenem and imipenem; Over 90% of the isolates were susceptible to cefepime, cefoperazone/sulbactam and piperacillin/tazobactam.The most active agent against Pseudomonas aeruginosa was meropenem (84%), followed by amikacin, piperacillin/tazobactam, ceftazidime and imipenem (72.5%-76.6%). Mutiple-drug-resistant Acinetobacter baumannii increased from 33% in 2003 to 48% in 2004. Resistance to carbapenems increased to 18% in this species in 2004. The most active agents against Burkholderia cepacia were meropenme (64.9%), cefoperazon/sulbactam (63.2%), ceftazidime (59.6%), piperacillin/tazobactam (56.1%) and cefepime (52.6%).Conclusions Carbapenems remained very high activity against Enterobacteriaceae. Increasing resistance to 10 antimicrobials agents tested among A. baumanni brought great concern. Meropenem was 4-to 16-fold more active against common gram-negative bacilli than imipenem.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.