Objective To study the correlation between anatomical measurement and CT measurement of adult occipital thickness so as to provide anatomic evidence for the selection of screw length in occipital-cervical fusion. Methods The occipital thickness was measured on the occipital specimens of 10 normal adults in two ways: direct anatomic measurement and CT measurement. Measurements were made on the basis of the McRac' s line and according to a matrix of 66 points following a grid with one cm spacing. The results of both measurements were statistically analyzed using SPSS 10.0. Results The results of both measurements were highly correlated. The external occipital protuberance was the thickest while the region of cerebellar fossa was the thinnest. The regions two cm lateral to the midline between plane Five and plane Six, one cm lateral to the midline between plane Four and at plane Five, and median between plane Three and plane Four were found to have a thickness of more than eight mm. Conclusions The occipital thickness varies with individuals. CT measurement and direct anatomic measurement are highly correlated. Preoperative CT measurements can be reliable evidence for optimal screw placement before performing occipital-cervical fusions.

Objective To investigate the efficacy and safety of glycoprotein Ⅱb/Ⅲa inhibitor (tirofiban) for elderly high-risk patients with acute coronary syndrome (ACS) undergoing percutaneous coronary interventional therapy (PCI). Methods Ninety four high-risk ACS patients admitted between Dec 2004 and Jul 2006 were randomly divided into the tirofiban group (n=46, mean age 68.5?11.4 years old) whom received tirofiban and half-dose of heparin, and the conventional interventional group (n=48, mean age 66.8?9.9 years old) whom were treated by full dose heparin before PCI. The coronary reperfusion flow (TIMI grades) of culprit vessel (CV) after PCI, cardiac enzyme changed 6 hrs and 12 hrs afterwards, major adverse cardiac events (MACE) rates within 30 days, bleeding and transfusion rates were analyzed and compared between the two groups. Results The average TIMI reperfusion grades (by frames) and CK-MB levels at 6 hrs and 12 hrs after PCI were better in the tirofiban group than in the conventional group (35.6?6.1, 16.2?3.9 mmol/L, 13.4?3.9 mmol/L vs 38.7?8.2, 18.4?4.8 mmol/L, 15.5?5.1 mmol/L, P

Objective Aim to set up the method of glycoprotein B genotype of human cytomegalovirus (HCMV) analysis by using nested polymerase chain reaction(nPCR) and restriction fragment length polymorphism(RFLP). Methods Eleven blood samples and twenty-three urine samples were obtained from thirty-four HCMV-infected patients. A fragment of gB gene was amplified by nPCR. HCMV gB genotyping was carried out by RFLP, and the amplified DNA fragments were verified by DNA sequencing. Results Of the 34 patients, gB type Ⅰ was found in 13 patients, gB type Ⅱ in 12 patients, gB type Ⅲ in 9 patients, and none had the gB type Ⅳ sequence. The similarities of PCR products of HCMV gB Ⅰ, Ⅱ and Ⅲ amplified compared with the sequences of prototype strains in GenBank were 98.1%～99.6%, 98.9%～100%, 97.3%～98.9%. Conclusions The nPCR assay developed in this study was sensitive and specific for detection of HCMV, and RFLP analysis of HCMV gB genotype was definite and reliable.

Objective:This study evaluated the economical effects of two different regimens for metastatic breast cancer, namely, paclitaxel plus either carboplatin (TP) or epirubicin (TE). Methods:The cost-effectiveness method in pharmacoeconomics was adopted to analyze retrospectively the two different regimens. Results:The median follow up was 23.5 (range:9 to 42) months. The overall response rate for TP and TE were 78.33%and 80.00%, respectively. The 1-and 2-year progression-free survival rates of TP and TE were 43.6%and 38.9%and 10.8%and 17.4%, respectively. The 1-and 2-year overall survival rates were 80.3%and 78.3%, respectively for TP, whereas the corresponding values for TE were 53.2%and 47.9%. No statistically significant difference was found between the two groups (P>0.05). Cost-effectiveness analysis showed that the average costs of the TP and TE regimens were 10 303.8 and 13 853.3 yuan, respectively, with corresponding cost-effectiveness ratios of 131.54 and 173.17 (P<0.01). For the chemotherapy toxicity, the alopecia reactions of the TP group were significantly lower than those of the TE group (P<0.01). Conclusion:The short-and long-term efficacies of the two regimens were similar. TP regimen was the optimal scheme for advanced metastatic breast cancer.

Objective: To study the effect of new photosensitizer Chlorophyl-derivative (CPD4) combined with Adriamycin on cell cycle and cell proliferation of MCF-7 breast cancer cell line and to investigate the mechanism of combination therapy. Methods: A new type of photosensitizer and traditional chemotherapy drug Adriamycin (ADM) were used to treat breast cancer cell line MCF-7. Flow cytometry was employed to detect apoptosis rate and cell cycle distribution in ADM group, group with photodynamic effect and the combined group. The influence of ADM on the mean fluorescence intensity and the changes in the mean fluorescence intensity after CPO4 (1.5μg/mL) treatment were analyzed. Results: The apoptosis rate of the combination group was higher than that in the other two groups, with statistical significance (P＜0.01). Photodynamic effect caused G_0/G_1 phase arrest in MCF-7 cells. Low concentration of ADM increased the number of G_2/M phase cells. The percentage of G_2/M phase cells was increased in the combination group. No significant difference was found in the mean fluorescence intensity between ADM pretreated MCF-7 cells for 24 hours and 48 hours and the control group (P＞0.05). Pretreatment of MCF-7 cells with ADM increased the volume of photosensitizer CPD4 into the cells. The mean fluorescence intensity at 2 hours after CPD4 incubation was the highest. Conclusion: ADM can increase the amount of CPD4 into the MCF-7 cells. Photodynamic therapy com-bined with Adriamycin has a synergistic effect on MCF-7 cells.

Objective:To evaluate the effectiveness and safety of using apatinib in the treatment of refractory triple-negative advanced breast cancer. Methods:Eight cases of advanced triple-negative breast cancer patients confirmed via histopathology, who were previously treated with anthracycline, taxane, gemcitabine, capecitabine, and 500 mg/d apatinib in our hospital from July 2015 to November 2016, were retrospectively analyzed. The time of disease progress, effective rate, clinical benefits, and side effects were observed. Results:Eight patients were administrated with an average of 4 treatment cycles, and the effects were evaluated after 2 weeks. Four patients exhibited partial remission, 3 had a stable disease, and 1 had a progressive disease. The disease control rate was 87.5%, and the median progression free survival was 4.2 months. The main side effects were hand-foot syndrome (3/8), bone marrow arrest (4/8), hypertension (2/8), proteinuria (3/8), hemoptysis (1/8), nausea (2/8), and fatigue (2/8). Most of these side effects were tolerable. Conclusion:Apatinib can effectively and tolerably prolong survival time and improve the quality of life of patients with advanced triple-negative breast cancer.

Objective To profile the intraspecific type of Trichophyton mentagrophytes clinically isolated from different anatomical sites of patients, and to compare the performance of different target sites for the identification of Trichophyton mentagrophytes complex strains. Methods A total of 48 Trichophyton mentagrophytes strains, which were clinically isolated from Department of Dermatology, Wuhan No. 1 Hospital in the latest 3 years, were included in this study. The phenotypes of these Trichophyton mentagrophytes isolates were primarily determined by morphological observation and the urease test. PCR was performed to amplify the nuclear ribosomal internal transcribed spacer(ITS) region and the D1?D2 domains of the large?subunit ribosomal DNA(28S rDNA)followed by DNA sequencing. Then, Clustal X2 software and MEGA 6.0 software were used to analyze the ITS and D1?D2 sequences and to build phylogenetic trees by the maximum?likelihood method (bootstrap = 2000). Results As the ITS sequence?based phylogenetic tree showed, the probability that the 48 isolates were grouped into the Trichophyton interdigitale clade reached 92%. However, Trichophyton interdigitale could not be effectively differentiated from Trichophyton quinckeanum by the D1?D2 sequence?based phylogenetic tree. In addition, Trichophyton interdigitale showed various appearances, including woolen type, downy type, cream type, powdery type and granular type. Conclusions Trichophyton mentagrophytes can be identified to the species level based on the sequence of ITS region, which shows higher efficiency in identifying Trichophyton mentagrophytes complex than the D1?D2 domains. Morphological characteristics can not serve as the basis for intraspecific typing of Trichophyton mentagrophytes.

Objective To investigate the infection rate of Legionella pneumophila(LP)in children younger than 5 years with lower respiratory infections by ELISA and PCR.Method Serum LP-IgM and IgG were measured by ELISA,and LP DNA in sputum or throat swab were detected by PCR in 300 children less than 5 years with lower respiratory infections.The data were analyzed by chi-square test and the consistency of the two methods was analyzea by NcNemar test.Results Serum antibody detected by ELISA was positive in 17 cases(5.67%),including 10 positive of IgM and 7 positiile of lgG.In these 17 eases,11 were males and 6 were females with similar positive rates(5.76%vs 5.5%).Four cases(2.53%)were positive in children aged from 27 days to 1 year,while 7(7.37%)and 6 cases(12.77%)were positive in children aged 1-3 years and 3-5 years,respectively.Seven cases(5.19%)found in the winter and spring seasons and 10 cases(6.06%)in summer and autumn seasons.Eleven children(11.83%)were from urban area and only 6(2.9%)from countryside.DNA in sputum or throat swab detected by PCR was positive in 16 cases(5.33%),included 10 males and 6 females with similar positive rates(5.24%vs 5.5%).Five cases(3.16%)were positive in children aged from 27 days to 1 year,while 6(6.32%)and 5 cases(10.64%)were positive in children aged 1-3 years and 3-5 years,respectively.Three cases(2.22%)found in the winter and spring seasons and 13 cases(7.88%)in sunmmr and alltumll seasons.Nine children(9.68%)were from urban area and only 7(3.38%)from countryside.McNemar test was used to compare the data of ELISA and PCR results with a Qm of 0.037 and a Pr of 0.8474.Conclusions LP might contribute partly to the lower respiratory infections in children less than 5 years.The infection rate of LP increases with age increasing.Urban children have a higher infection rate than those living in countryside.Both methods have a good consistency.

A 54-year-old female farmer presented with a pea-sized red nodule on the left upper limb near the wrist for 15 days,which occurred after trauma,gradually became swollen and ruptured,and developed into multiple nodules arranged in a chain in 30 days.Skin examination revealed multiple hard purple-red nodules arranged in a line on her left upper limb,some of which were ruptured with a small amount of purulent exndate.Histopathological examination further revealed that the focus of infection manifested as pyogenic granuloma-like inflammation mainly infiltrated with mixed inflammatory cells.Periodic acid Schiff (PAS) staining showed no fungal structures,including fungal spores,hyphae and asteroid body.The biopsy tissue culture yielded the fungus.According to the morphological analysis of the cultures and results of molecular identification based on internal transcribed spacer (ITS) and calmodulin (CAL) coding regions,this case was finally diagnosed as lymphocutaneous sporotrichosis caused by Sporothrix schenckii sensu stricto.The patient was treated with oral potassium iodide 10％ solution in a dose of 10 ml thrice a day.After 2-month treatment,the patient felt that the lesions were obviously improved,but afterwards she was lost to follow-up.This research report suggests that phenotypic analysis combined with ITS/CAL-based molecular identification can accurately identify Sporothrix schenckii complex at the species level.

10.3969/j.issn.1000-8179.2013.12.006