Objective To investigate the treatment methods for primary gastric lymphoma (PGL) and analyze the prognostic factors.Methods The clinical data of 55 patients with PGL who were admitted to the First Affiliated Hospital of Dalian Medical University from July 2002 to December 2007 were retrospectively analyzed.Operation,medication or operation combined with medication were applied to patients according to the pathological type,clinical staging,infection of helicobacter pylori and complications.Patients were followed up via phone call till February 2013,and the location,diameter,pathological type,clinical stage of the PGL and the treatment methods were recorded for prognostic analysis.The survival rate was calculated by Kaplan-Meier method,and the univariate analysis of survival was done by Log-rank test.Multivariate analysis was done by COX regression model.Results The PGL located at the gastric antrum in 26 cases,body of the stomach in 17 cases,fundus of the stomach in 5 cases,gastric cardia in 3 cases,body and antrum of the stomach in 4 cases.There were 46 patients with ulcerous PGL,5 with nodular PGL and 4 with diffused and infiltrated PGL.There were 53 B cell lympboma,1 T cell lymphoma and 1 undefined tumor.Of the 53 patients with B cell lymphoma,36 were with mucosa-associated lymphoid tissue lymphoma (MALTL) and 17 with diffuse large B-cell lymphoma (DLBCL).There were 23 patients in stage Ⅰ,23 in stage Ⅱ,4 in stage Ⅲ and 3 in stage Ⅳ.Of the 55 patients,23 received operation,14 received medication,17 received operation + medication,and 1 left untreated.Fifty-three patients had complete follow-up data.The median time of follow-up was 60 months (range,7-132 months).The 1-,3-,5-year cumulative survival rates were 91％,79％ and 72％.The results of univariate analysis showed that tumor diameter,pathological type and clinical staging were risk factors influencing the prognosis of PGL patients (x2 =9.34,6.59,88.01,P ＜ 0.05),while the treatment methods did not influence the prognosis of PGL patients (x2 =3.63,P ＞ 0.05).The results of multivariate analysis showed that DLBCL,clinical stages Ⅲ and Ⅳ were independent risk factors influencing the prognosis of PGL patients (OR =5.758,2.231,95％ confidence interval:2.536-13.073,1.370-3.625,P ＜ 0.05).Conclusion Multi-disciplinary team treatment should be recommended for PGL patients.Pathological type (DLBCL) and clinical stages (stage Ⅲ and Ⅳ) are the independent risk factors influencing the prognosis of PGL patients.

Objective To explore the relationship between the C677T single nucleotide polymorphism of N5, N10-methylenetetrahydrofolate reductase (MTHFR) and blood stasis syndrome (BSS) of ischemic stroke (IS). Methods The MTHFR C677T genotypes in 84 patients of IS of BSS type (BSS-IS group), 143 patients of IS of non-BSS type (non-BSS-IS group) were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Results The constituent ratio of MTHFR CC, CT and TT genotype was significantly different between two groups (? 2 =12.618;d.f.=2, P=0.002). The frequencies of T allele in patients with BSS-IS (39.29%) were higher than that of non-BSS-IS group (24.48%). The MTHFR TT genotype was associated with a 3.730-fold increased risk for BSS-IS (OR=3.730;95%CI, 1.229～11.318; P =0.014). Conclusion The MTHFR TT genotype may be one of the risk factors associated with the susceptivity to BSS-IS.

Objective To investigate the clinical value of 3.0T MRI for hilarcholangioc-arcinoma diagnosis.Methods T Totally48 hilarcholangiocarcinoma patients from October 2011 to June 2015 underwent diagnoses by 3.0T MRI and 64-slice spiral CT,and then the diagnosing results were compared with those by surgery and pathological examination to determine the value of 3.0T MRI for hilarcholangiocarcinoma diagnosis.Results 3.0T MRI had the positioning accuracy (100％) and qualitative accuracy (95.83％) significantly higher than the positioning accuracy (79.17％) and qualitative accuracy (81.25％) (P＜0.05).In case of hepatic duct dilatation,CT found 35 cases of hilar masses,14 cases of lymphoma,5 cases of hepatic duct wall invasion and 9 cases of portal vein invasion,while 3.0T MRI displayed 44 cases of hilar masses,26 cases of lymphoma,13 cases of hepatic duct wall invasion and 30 cases of portal vein invasion.Conclusion 3.0T MRI has high positioning and qualitative accuracies when used to diagnosing hilarcholangiocarcinoma,behaves well in displaying hepatic duct dilatation,high resolution of soft tissues,and thus is worthy promoting clinically.

OBJECTIVEThis longitudinal study aimed to investigate the caries status of primary and permanent teeth among 6-year-old children in Sichuan Province from 2010 to 2012.

METHODSA sample that comprised 652 6-year-old children from six different elementary schools (three represented the urban areas, and the other three represented the rural areas) were examined according to a baseline, with follow-up examinations at 1, 2, and 3 years. Eruption and caries experience were re- corded using World Health Organization criteria.

RESULTSThe prevalence rates of primary tooth caries of 6-year-old children in Sichuan Province for 3 years were 74.23% (484/652), 75.61% (493/652), and 81.90% (534/652). The filling rate of the primary teeth was 5.87% (145/2,471) in 2012, with significant differences (P < 0.01) between the urban areas [10.84% (133/ 1,227)] and rural areas [0.96% (12/1,244)]. The total pit and fissure rate of the first molar was 14.11% (92/652) in 2012, with significant differences between the two areas (P < 0.01) [rural: 0.66% (2/303); urban: 25.79% (90/349)].

CONCLUSIONThe pre- valence of caries in the primary and permanent teeth of 6-year-old children was high. An increasing prevalence tendency was observed as the age increased. The prevalence of first molar caries indicated that prevention and control of dental caries should be performed as early as possible.

Child ; China ; DMF Index ; Dental Caries ; Dentition, Permanent ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Molar ; Prevalence ; Tooth Eruption ; Tooth, Deciduous

Objective To evaluate the effects of different doses of dexmedetomidine on propofol-induced inhibition of responses to laryngeal mask airway (LMA) insertion when combined with fentanyl in patients undergoing gynecological operation.Methods One hundred and twenty-five ASA Ⅰ-Ⅱ female patients,aged 20-60 yr,scheduled for elective short-time surgery,were randomly divided into 5 groups (n =25 each):normal saline group (group NS) and different doses of dexmedetomidne groups (groups D1-4).Normal saline 40 ml and dexmedetomidne 0.4,0.6,0.8,1.0 μg/kg (in 40 ml of normal saline) were infused over 10 min in groups NS and D1-4,respectively.1％ propofol was then given by target-controlled infusion.The concentration of propofol was determined by using modified Dixon's up-and-down method.The initial plasma concentration of propofol was 3.0 μg/ml and the ratio between the 2 successive concentrations was 1.1.Fentanyl 1.5 μg/kg was injected intravenously when the effect-site concentration of propofol reached the preset plasma concentration.LMA was inserted 4 min later.When LMA insertion was successful,the concentration of propofol was decreased in the next patient and when LMA insertion failed,the concentration of propofol was increased in the next patient.Failure of LMA insertion was defined as difficulty in inserting LMA or body movement,corner of mouth movement,biting LMA,swallowing and/or lacrimation during insertion.The median effective target effect-site concentration and 95％ confidence interval of propofol blunting responses to LMA insertion when combined with fentanyl were calculated.Results The median effective target effect-site concentration (95％ confidence interval) of propofol blunting responses to LMA insertion when combined with fentanyl were 3.09 (2.83-3.36),2.48 (2.26-2.73),2.29 (2.18-2.41),2.04 (1.95-2.12) and 1.67 (1.55-1.81) μg/ml in groups NS and D1 4,respectively.Conclusion Dexmedetomidine can enhance propofol-induced inhibition of responses to LMA insertion when combined with fentanyl in dose-dependent manner in patients undergoing gynecological operation.

Objective:To study the preparation and quality control of loxoprofen sodium patches and develop an HPLC method for the determination of loxoprofen sodium. Methods:Loxoprofen sodium patches were prepared with CMC-Na and PVP as the adjuvants, and an HPLC method was used to determine the content of loxoprofen sodium. Results:The linear range of loxoprofen sodium was 4-24μg·ml-1(r=0. 999 7), the average recovery was 99. 99%(RSD=0. 99%, n=6). Conclusion:The preparation method is reason-able, simple and stable. The developed HPLC method is specific to determine the content of loxoprofen.

Objective To analyze the risk factors of subclavian venous catheter-related infections in patients with traumatic hemorrhagic shock (THS) and provide a basis for prevention and control of the infection. Methods A retrospective study was conducted. 357 patients with THS and indwelling of subclavian vein catheter admitted in the Department of Emergency of Affiliated Hospital of Sichuan Provincial Luzhou Medical College were enrolled, and according to the infection state, they were divided into infection group (56 cases) and non-infection group (301 cases). The patients' data of gender, age, history of underlying disease, catheter position, catheter indwelling time, time staying in hospital, situation of antimicrobial drug used, application of tracheotomy or not, white blood cell count (WBC) levels, etc were collected for univariate analysis. The resulting indexes with statistical significance were applied for carrying out the multivariate logistic regression analysis, and then the independent risk factors involved in the development of subclavian venous catheter-related infections in the shock patients could be screened out.Results In 357 patients with THS, 56 were infected (15.7%). Univariate analysis showed: age ≥ 60 years (χ2 = 19.839,P < 0.001), with diabetes mellitus in past history (χ2 = 6.252,P = 0.012), catheter indwelling time ≥ 7 days (χ2 = 19.261,P < 0.001), time staying in hospital ≥ 7 days (χ2 = 4.315,P = 0.038), time for use of antimicrobial drug≥ 7 days (χ2 = 16.161,P < 0.001), tracheotomy (χ2 = 40.969,P < 0.001), WBC < 4×109/L (χ2 = 39.451,P < 0.001) and the disease severity grade 4 - 5 (χ2 = 8.345,P = 0.004) were the risk factors of subclavian venous catheter-related infections in patients with THS. Multivariate analysis showed: catheter indwelling time ≥ 7 day [odds ratio (OR) = 16.713, 95% confidence interval (95%CI) 3.651 - 76.624), tracheotomy (OR = 6.861, 95%CI 2.377 - 18.246), WBC < 4×109/L (OR = 4.903, 95%CI 1.887 - 12.643) were the independent risk factors of subclavian venous catheter-related infections in THS patients.Conclusion The strict implementation of aseptic catheterization, shortening the time of catheter indwelling as much as possible and the rational use of antibiotics can effectively reduce and prevent the incidence of venous catheter-related infection in THS patients.

Objective To systematically review the efficacy and safety of Jinlian Qingre Effervescent Tablet (JQET) compared to Ribavirin for acute upper respiratory tract infection in children.Methods CNKJ,CBM,WanFang Data,VIP,PubMed,EM base,Web of science,and Cochrane Library databases were searched from the date of establishment to December 2016 for all randomized controlled trials (RCTs) and quasi-RCT on the use of JQET in children with acute respiratory infections.Meta-analysis by using Rev Man 5.3.Results A total of seven RCTs involving 782 patients were included,while the group of JQET involving 392 patients,Ribavirin involving 390 patients.The results ofmeta-analysis indicated that the efficacy in Jinlianqingre group was superior to that of Ribavirin control group,such as clinical effectiveness [RR=l.26,95％CI=(1.18,1.34),P＜0.000 01],fever subsidence time [MD=-1.54,95％CI (-1.79,-1.30),P＜0.000 01],the time of subsided cough [MD=-1.53,95％CI (-1.79,-1.27),P＜0.000 01],the disappearance time of pharyngalgia [MD=-1.29,95％CI (-1.88,-0.70),P＜0.000 1],and Pharyngeal congestion disappearance time [MD=-2.80,95％CI(-3.11,-2.49),P＜0.000 01].The difference was statistically significant.There were three adverse reactions reported in JQET group.Conclusion JQET is superior to the Ribavirin control group in clinical effectiveness,fever subsidence time,time of subsided cough,disappearance time of pharyngalgia,and pharyngeal congestion disappearance time to treat acute upper respiratory tract infection in children.However,these results should be carefully interpreted,and this conclusion has to be further verified by high quality,large scale RCTs.

The underlying effect of different concentrations of neogenin on proliferation, apoptosis and the related proliferative factors in human trophoblasts was explored in order to understand the function of neogenin during placentation. TEV-1 cell line was cultured and the expression of netrin-1 was detected by using indirect cellular immunofluorescence. Exponentially growing TEV-1 cells were treated by different concentrations of neogenin (0, 1, 5, 10, 50 ng/mL) for 24 h. Cell viability was measured by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. TEV-1 cell apoptosis was assessed by flow cytometry (FCM). The expression of netrin-1 mRNA and protein in TEV-1 cells was examined by using real-time PCR and Western blot, respectively. It was found that immunoreactivity for netrin-1 was observed in cytoplasm of the trophoblasts. Immediately after treatment with different concentrations of neogenin for 24 h, the netrin-1 expression began to increase. Real-time PCR revealed that the expression level of netrin-1 mRNA was 37.59+/-10.25 times higher than control group when TEV-1 cells were exposed to 50 ng/mL neogenin (P<0.01), and the same tendency was seen by using Western blot. MTT results showed that proliferation of TEV-1 cells was independent of neogenin. Meanwhile, apoptosis was significantly increased to (22.15+/-6.15)% at 50 ng/mL neogenin and (6.55+/-0.25)% without neogenin (P<0.01). It is suggested that neogenin regulates proliferation and apoptosis of TEV-1 cells. And it can enhance the ability of TEV-1 cells to express netrin-1 in a dose-dependent manner. Neogenin may play an important biological role in the normal human pregnancy and contribute to the physiological pregnancy process.

To explain how to ensure and improve the quality of the clinical practice teaching for the clinical institutes,we expatiate on the practical experience in the hospital from enhancing the practice teaching management,improving the teaching consciousness,meliorating the teaching environment and reforming the method.