Administration, Cutaneous ; Amoxicillin ; therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Penicillins ; therapeutic use ; Phytotherapy ; Respiratory Tract Infections ; drug therapy ; prevention & control ; Secondary Prevention

Objective To investigate the effect of recombinant human endostatin combined with chemotherapy on the expression of vascular endothelial growth factor (VEGF) in patients with advanced cancer.Methods250 patients with advanced malignant tumors were randomly selected from February 2012 to February 2016 the Third Hospital of Jiaxing, with unit control method experiment principle divided into two groups: experimental group (125 cases) and control group (125 cases).The experimental group treated by recombinant human endostatin combined chemotherapy, control group received routine chemotherapy for a week during the period of 21 days, after two cycles of treatment, clinical efficacy and adverse reactions of the two groups of patients were compared, and the expression of VEGF in tumor blood vessels weredetected.ResultsAfter two cycles of treatment, objective response rate, disease control rate in the experimental group patients was significantly higher than that in control group (P<0.05);after treatment, the expression level of VEGF in serum of the experimental group and the control groupwere decreased significantly, but the experimental group was lower than that of control group was more obvious (P<0.05).ConclusionRecombinant human endostatin combined with chemotherapy in the treatment of advanced malignant tumors can enhance the effect of chemotherapy, regulate the level of VEGF.

Objective To investigate clinical therapeutic effects after a series of improvements of multi-site combination in the simple obese patient with tumescent liposuction. Methods Before tumescence anesthetization, short-acting benzo-diazepine was used as sedative inducer. The pressure and fluid velocity of short-acting benzodiazepine were regulated and injected into deeper level of fat at first, and all of these actions decreased the pain of patients, and promote the effect of the pain tolerance. The positions of the incisions were selected to hide from view and specifically protected, which could improve looks and decrease the scar formation after operation. In later stage of operation the flaps were pressurized and slid from outside, in order to make the flaps even and smooth and to keep their thickness according to the position of the flaps and the age of the patients. Opened draining was changed to block draining after operation. Results 73 cases were taken the follow-up for 6～24 months. All cases obtained satisfactory results, except that one cases was complicated by scar hypertrophy. The changes of the circumferences were as follows: the decrease of the maximum circumference of thigh was from 2 cm to 17cm, abdomen from 3 cm to 24 cm, and buttocks from 1 cm to 3 cm. Conclusions A series of improvement of key measures enhance the clinical therapeutic effects of multi-site combination in the simple obese patient with tumescent liposuction.

Objective To observe the effect of dexmedetomidine on patients′ inflammation during CPB and protective effect on kidney and liver. Methods 60 cases undergoing cardiac valve replacement under CPB were randomly divided into NS group and Dex group. Blood samples were taken before induction , before ascending aorta blocked, end of CPB, 24, 48 and 72 hours after operation. The serum level of HMGB-1, TNF-α, IL-6, BUN, Cr and ALT are tested. Blood WBC and N% are also counted. Results WBC, N% and HMGB-1, TNF-α, IL-6, BUN, Cr in Dex group significantly decreased at time point T2 ~ T6 (P < 0.05) compared with NS group. But ALT in Dex group only decreased at time point T 2 and T5 compared with NS group (P < 0.05). Conclusion Dexmedetomidine can significantly decrease inflammatory factor during CPB and improve renal function after surgery.

Objective To detect the gene expression difference between gastric cancer tissue and lymph node metastasis,screen different express genes,and study its mechanism of metastasis and the relationship with biological behavior.Methods Using U133plus 2.0 gene chip technology,we detected the gene expression difference between gastric cancer tissue and epithelial cells of lymph node metastasis in five patients,and screened out the differentially expressed gene Twist-l.In vitro,the cell proliferation and apoptosis level were measured by using gene over-expression and gene knockout.Metastasis ability of carcinoma cells was detected by cell scratch assay.The expression changes of epithelial-mesenchymal transition (EMT)-associated protein (E-cadherin,Vimentin) in Twist-1 overexpression and gene knockout cells were determined by Western blot.Finally,we detected the expression of Twist-1 in gastric cancer tissue,and its correlation with TNM stage was analyzed.Results The expression of Twist-1 was higher in epithelial cells than in gastric cancer tissue (12.12±3.21 vs.2.07±0.71,P＜0.01).There was no correlation of the expression of Twist-1 with cell proliferation(absorbance of cell proliferation:negtive control 0.84±0.16,null vector control 0.74 ±0.06 and Twist-1 expression cell 0.71 ± 0.07) and apoptosis [cell apoptosis rate:negtive control (2.05±0.08)％,null vector control (4.31±0.07)％ and Twist-1 expression (3.95±0.09)％],but cell migration ability enhanced.In Twist-1 over-expression group,the level of E-cadherin was decreased,while vimentin increased.Conclusions Twist-1 gene changes might be correlated with the metastasis of gastric cancer by the way of EMT.

ObjectiveTo observe the clinical effects of mirabilite external application and neostigmine injection at Zusanli acupoint combined with Xuebijing intravenous injection on patients with severe sepsis.Methods A history-prospective controlled study was conducted. Patients with severe sepsis admitted to the Fourth People's Hospital of Jiangsu University from January 2012 to November 2015 were enrolled. Twenty-one cases admitted from January 2014 to November 2015 were assigned as a research group and treated with application of mirabilite external application, Zusanli acupoint injection of neostigmine combined with intravenous Xuebijing injection; 22 patients with Xubijing treatment from January 2012 to November 2015 were included in a Xubijing group; 21 patients with routine therapy from January 2012 to November 2013 were included in a control group. The changes of white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), mean arterial pressure (MAP), oxygenation index (OI), serum creatinine (SCr), acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, sequential organ failure assessment (SOFA), gastrointestinal function score, blood platelet count (PLT), plasma prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimmer in three groups before and after treatment were observed; the length of stay in ICU and the 28-day mortality were compared among the three groups. Results Compared with those before treatment, WBC, PCT, CRP, SCr, APACHE Ⅱ score, SOFA score, gastrointestinal function score, APTT, PT, and D-dimer were all obviously lower after treatment for 7 days in various groups; OI, MAP, PLT were significantly higher, and the improvement degree of WBC, PCT, CRP, SCr, APACHE Ⅱ score, SOFA score, gastrointestinal function score, OI in research group was more significant than those of control group and Xubijing group [WBC (×109/L): 7.52±0.75 vs. 12.87±4.13, 10.88±0.66, PCT (μg/L): 1.14±0.55 vs. 6.32±1.39, 3.47±1.94, CRP (mg/L): 21.0±9.2 vs. 65.0±13.6, 35.0±13.9, OI (mmHg, 1 mmHg = 0.133 kPa): 357.0±20.4 vs. 295.0±20.4, 309.0±21.4, SCr (μmol/L): 7.89±2.35 vs. 14.33±9.17, 11.27±4.65, APACHE Ⅱ score: 10.38±0.75 vs. 18.27±2.57, 13.09±4.10, SOFA score: 1.05±0.66 vs. 6.01±2.33, 3.26±1.03, gastrointestinal function score: 0.31±0.11 vs. 2.01±0.46, 1.85±0.29, all P < 0.05], the improvement of PLT, APTT, PT, D-dimer indicators in the research group was more significant than those in control group, but the above improvement compared with that in Xubijing group, no statistically significant difference was found [PLT (×109/L): 220.32±32.44 vs. 105.56±44.03, 170.56±54.03, APTT (s): 30.16±5.23 vs. 39.09±10.11, 29.56±6.85, PT (s): 10.74±1.25 vs. 13.56±4.65, 10.05±1.44, D-dimer (mg/L): 1.13±1.98 vs. 4.03±2.65, 1.13±0.54]. The length of stay in ICU was shortened in research group than that in control group and Xubijing group (days: 13.23±9.45 vs. 25.22±15.46, 18.56±10.33, P < 0.05); the 28-day mortality was significantly lower in the research group than that in the control group [28.6% (6/21) vs. 47.6% (10/21), P < 0.05], but there was no statistically significant difference compared with that in Xubijing group [28.6% (6/21) vs. 31.8% (7/22), P > 0.05]. Conclusions The treatment of mirabilite external application and neostigmine injection at Zusanli acupoint combined with Xuebijing intravenous injection can obviously improve the clinical symptoms, blood coagulation indexes and organ functions, reduce the levels of inflammatory indexes, shorten the time of the length of stay in ICU and elevate the survival rate of patients with severe sepsis.

Objective To investigate the effect of meridian exercises on blood glucose and clinical symptoms of community elderly type 2 diabetic patients.Methods Sixty elderly patients with type 2diabetes mellitus (T2DM) were selected from two communities from February to September in 2012.Thirty participants from one community received meridian excise-based group sport management (experiment group),the other 30 subjects from another community got meridian excise-based individual sport management (control group).Before and after the intervention,blood glucose and self-report symptoms were assessed.Results At baseline and after the intervention,there was statistically significant difference of postprandial blood glucose and self-symptom score between the two groups (t values were-5.954,-2.900,-4.214 and-3.798,respectively; all P＜0.05).After the intervention,experiment group showed statistically significant difference in self-assessment of symptom score from the control group (t=-5.484,P＜0.05).Conclusion Meridian exercises can efficiently improve diabetic patients' postprandial blood glucose and clinical symptons.

Objective To analyze the clinical data of recipients over 15 years after renal transplantation,and to find the factors that affect the long-term survival of recipients after renal transplantation.Method Before June 30,2000,326 renal transplant recipients in our hospital were collected retrospectively.The risk factors which affect the survival of kidney transplant recipients and kidney were analyzed from four dimensions.A Cox model was established to analyze these multi factors.Result Cox hazard model indicated that advanced age (P=0.010,RR =1.052),AMR (P＜0.001,RR =18.311),nonadherence (P =0.001,RR =2.854),smoking (P =0.025,RR =2.097)were the risk factors for recipients' survival.Using immunosuppressive regimen FK506 + MMF+ Pred (P =0.019,RR =0.433),or CsA + MMF + Pred (P =0.019,RR =0.413) was the protective factor for recipients' survival.Nonadherence (P＜0.001,RR =5.645),and diabetes (P＜0.001,RR =3.310) were the risk factors of grafts' survival.Using immunosuppressive regimen FK506 + MMF + Pred (P＜0.001,RR =0.236),or CsA + MMF + Pred (P =0.002,RR =0.317) was the protective factor of grafts' survival.Conclusion To enhance the long-term outcome of recipients and grafts,the individualization of immunosuppressive regiments and controlling of the chronic diseases progress by changing the unhealthy life style are cutting on edge.

Objective To investigate the expression and clinical significance of RegⅣand EGFR,PI3K proteins in gastric adenocarcinoma .Methods S-P immunohistochemistry was used to detect the expression of RegⅣand EGFR,PI3K proteins in pathological tissues of 73 cases with gastric adenocarcinoma and tumor -adja-cent normal gastric tissues .Results The positive expression rates of RegⅣand EGFR,PI3K proteins in 73 cases with gastric adenocarcinoma tissue were 50.7%(37/73),56.2%(41/73) and 69.9%(51/73) respectively, which were significantly different from the positive expression rates of tumor -adjacent normal gastric tissues ,be-ing 20.5%(15/73),19.2%(14/73),and 21.9%(16/73),respectively(P<0.05).The expression of RegⅣprotein was significantly correlated to differentiation degree ( P<0.05 ) and the expression of EGFR protein was significantly correlated to infiltrative depth,TNM stage,and lymph node metastasis(P<0.05).The expression of PI3K protein was significantly correlated to differentiation degree ,infiltrative depth,TNM stage and lymph node metastasis(P<0.05).There was positive correlation between the expressions of RegⅣ/EGFR,RegⅣ/PI3K and EGFR/PI3K proteins in gastric adenocarcinoma and the values of Spearman coefficient correlation were 0.325, 0.403 and 0.384,respectively(P<0.05).Conclusion RegⅣmay play an important role in gastric adenocarci-noma genesis and progression by activating EGFR /PI3K/Akt signaling pathway .

Objective To investigate the association between CYP2C19 polymorphisms and efficacy of clopidogrel in Chinese Han patients with coronary atherosclerotic heart disease.Methods A total of 176 Chinese Han patients who underwent percutaneous coronary intervention and were treated with dual antiplatelet therapy with aspirin and clopidogrel were enrolled.Polymorphisms of CYP2C19 * 2,* 3 were measured by PCR-restriction fragment length polymorphism (PCR RFLP).The correlation between the genetic variants and cardiovascular events was analyzed.Results In the 176 patients,the allele frequencies of CYP2C19 * 2 and * 3 were 34.38％ and 5.97％ respectively,the percent of patients with poor metabolizer genotypes (* 2/* 2,* 2/* 3,* 3/* 3) was 14.20％.Among the 176 patients,11 patients reoccured acute coronary syndrome,1 patient suffered from stroke,and 4 patients had stent thrombosis.The incidence of cardiovascular events was 9.09 ％.Thecumulative incidence of cardiovascular events had no significant differences between poor metabolizer genotype carriers and extensive and intermediate metabolizer genotype carriers (16.00％ vs.7.95％,x2 =1.683,P=0.195).Conclusions The frequencies of CYP2C19 poor metabolizer genotypes are higher in Chinese Han population than in Caucasians,but the incidence of cardiovascular events in Chinese Han population is not increased.