Objective : To analyze the application value of metagenomic next-generation sequencing (mNGS) in the detection of pathogenic bacteria in pulmonary infection ，and to provide a theoretical basis for clinical diagnosis. Methods : A retrospective study was conducted on 161 patients with suspected pulmonary infection，and samples of bronchoalveolar lavage fluid ，sputum and lung tissue were collected specimens ，pleural effusion and blood were simultaneously subjected to routine culture，respiratory pathogen nucleic acid detection and pathogenic microorgan- ism mNGS detection．The sensitivity ，specificity，positive predictive value ，and negative predictive value of the three detection methods were calculated respectively to evaluate the clinical application value of mNGS. Results: Among 161 patients with suspected pulmonary infection，113 cases were finally confirmed as pulmonary infection. Among the 161 patients enrolled，the sensitivity and negative predictive value of mNGS were improved compared with routine culture and nucleic acid detection of respiratory pathogens，and the difference was statistically signifi- cant(P＜0. 001) ．Although the specificity of mNGS was higher than that of respiratory pathogen nucleic acid de- tection，the difference was not statistically significant．The positive predictive value of mNGS was the highest，and was higher than that of respiratory pathogen nucleic acid detection，but had no statistical significance compared with conventional culture． Conclusion The sensitivity of mNGS in the diagnosis of pathogenic microorganisms in pul- monary infection is higher than that of conventional culture and nucleic acid detection of respiratory pathogens， which reduces the false negative rate of diagnosis and has a better comprehensive evaluation ; conventional culture detection has low sensitivity，but high specificity ; respiratory pathogen nucleic acid detection compared with con- ventional culture，the sensitivity is improved，but the specificity decreased.

Objective To investigate the advantages and disadvantages of oxycodone combined subarachnoid block and intravenous-inhalational anesthesia in elderly patients with femoral trochanter fracturethe surgery.Methods Thirty-four patients undergoing elective surgery with closed reduction and Proximal femoral nail anti-rotation (PFNA) fixation,13 males and 21 females,aged 76-92 years,ASA physical status Ⅱ or Ⅲ,were equally randomized into two groups (n =17 each):group O and group C.Patients in group O received oxycodone combined subarachnoid block.Patients in group C received intravenous-inhalational anesthesia.Patients in group C were not premeditated beforel entering the operation room.After entering the rooms group O was given oxycodone 3-5 mg i.v first,then given ropivacaine in subarachnoid space.All patients were induced with intravenous of sulfentanil 0.2-0.3μg/kg,cisatracurium 0.15 mg/kg,etomidate 0.1-0.2 mg/kg slowly.Anesthesia was maintained by intravenous propofol 3-5 mg· kg-1 · h-1,remifentanyl 0.1-0.3 μg · kg-1 · h-1,sevofrane 0.55％-2％ infusion,intravenous bolus cisatracurium 0.05-0.10 mg/kg.The anesthesia related complications and length of hospital stay were recorded.Results Postoperative nausea and vomiting (PONV) respiratory depression of group O was significantly lower than that of group C [2(11.8％) cases vs 9 (52.9％) cases,P＜0.05],length of hospital stay of group O was significantly shorter than that of group C [(10.4±1.6) d vs (15.8±2.0) d,P＜0.05].Conclusion In the elderly patients with femoral intertrochanteric fracture closed reduction and PFNA internal fixation,oxycodone combined subarachnoid block may improve patients' recovery.

Objective To investigate the species and hosts of Paragonimus and its infection rate in eastern part of Zhenghe County,Fujian Province,so as to determine the local foci of Paragonimus. Methods The snails,crabs and stools of wild cats were collected for the examinations of cercariae,metacercariae and eggs of Paragonimus. The geographical and environmental conditions of the areas were also investigated. Results A total of 4 890 Pseudobythinella jianouensis snails and 1 035 Semisul?cospira liberlina snails were examined,and the cercariae of Paragonimus were only found in P. jianouensis,with an infection rate of 0.10%(5/4 890). Bottapotamon zhengheensis sp. nov. as the second intermediate host of P. skrjabini,were examined, and the infection rate was 85.29%(29/34)and the average numbers of metacercariae per crab and per gram of crab tissues were 3.85 and 0.62,respectively. Thirty?six Sinopotamun fujianensis crabs,as the second intermediate host of P. westermani,were examined,and the infection rate was 38.89%(14/36)and the average numbers of metacercariae per crab and per gram of crab tissues were 6.43 and 0.03,respectively. The eggs of Paragonimus were detected in 1 of 2 muck specimens of wild cats. Conclu?sion The data suggest that there is a focus of middle?to?high level of infection caused by P. westermani and P. skrjabini in the eastern part of Zhenghe County.

OBJECTIVETo evaluate the impact of primary site, NIH risk and imatinib treatment on the prognosis of patients with gastrointestinal stromal tumors(GIST).

METHODSClinicopathological data of 156 adult patients with GIST treated by imatinib in the Cancer Institute and Hospital of Tianjin Medical University from January 2006 to December 2010 were retrospectively analyzed. According to NIH risk classification, 30 patients were at moderate risk and 126 at high risk. Sixty-seven patients had advanced GIST. Prognosis of patients with different primary tumor site, different NIH risk and different treatment was compared respectively.

RESULTSImatinib therapy was well tolerated in all the patients. Eighty-nine cases received radical operation and adjuvant imatinib treatment. Among 67 advanced GIST cases, 26 received radical operation and adjuvant imatinib treatment, 27 received palliative operation and adjuvant imatinib treatment, and 14 received simple adjuvant imatinib treatment without operation. All the patients had routine follow-up, ranging from 9 to 56(median 27) months. The overall survival (OS) rate was 96% in 1-year, 86% in 2-year, and 71% in 3-year. The OS rate was 95% in 1-year, 77% in 2-year, and 65% in 3-year for patients at high risk, and all 100% in 1-, 2-, 3-year for patients at moderate risk, the differences was statistically significant (P=0.001). The OS rate was 97% in 1-year, 90% in 2-year, and 84% in 3-year for patients with gastric GIST, and 95% in 1-year, 69% in 2-year, and 52% in 3-year for patients with non-gastric GIST, the difference was significant(P=0.000). The OS rate was 98% in 1-year, 95% in 2-year, and 90% in 3-year for patients undergoing radical resection and adjuvant imatinib therapy. For 67 advanced GIST patients with imatinib therapy, none had complete remission, 41 had part remission, 15 had stable disease, indicating 56 advanced GIST cases(83.6%) obtaining clinical benefit. The OS rate was 91% in 1-year, 58% in 2-year, and 43% in 3-year.

CONCLUSIONSThe prognosis of high, and non-gastric and advanced GIST patients is poor. Radical resection combined with early imatinib treatment can improve the prognosis of GIST patients.

Antineoplastic Agents ; therapeutic use ; Benzamides ; therapeutic use ; Combined Modality Therapy ; Follow-Up Studies ; Gastrointestinal Neoplasms ; drug therapy ; pathology ; Gastrointestinal Stromal Tumors ; drug therapy ; Humans ; Imatinib Mesylate ; Piperazines ; therapeutic use ; Prognosis ; Pyrimidines ; therapeutic use ; Retrospective Studies ; Survival Rate

Objective To evaluate the impact of primary site, NIH risk and imatinib treatment on the prognosis of patients with gastrointestinal stromal tumors (GIST). Methods Clinicopathological data of 156 adult patients with GIST treated by imatinib in the Cancer Institute and Hospital of Tianjin Medical University from January 2006 to December 2010 were retrospectively analyzed. According to NIH risk classification, 30 patients were at moderate risk and 126 at high risk. Sixty-seven patients had advanced GIST. Prognosis of patients with different primary tumor site , different NIH risk and different treatment was compared respectively. Results Imatinib therapy was well tolerated in all the patients. Eighty-nine cases received radical operation and adjuvant imatinib treatment. Among 67 advanced GIST cases, 26 received radical operation and adjuvant imatinib treatment, 27 received palliative operation and adjuvant imatinib treatment, and 14 received simple adjuvant imatinib treatment without operation. All the patients had routine follow-up, ranging from 9 to 56 (median 27) months. The overall survival (OS) rate was 96% in 1-year, 86% in 2-year, and 71% in 3-year. The OS rate was 95% in 1-year, 77% in 2-year, and 65% in 3-year for patients at high risk, and all 100% in 1-, 2-, 3-year for patients at moderate risk, the differences was statistically significant (P=0.001). The OS rate was 97%in 1-year, 90% in 2-year, and 84% in 3-year for patients with gastric GIST, and 95% in 1-year, 69%in 2-year, and 52%in 3-year for patients with non-gastric GIST, the difference was significant(P=0.000). The OS rate was 98% in 1-year, 95% in 2-year, and 90% in 3-year for patients undergoing radical resection and adjuvant imatinib therapy. For 67 advanced GIST patients with imatinib therapy , none had complete remission, 41 had part remission, 15 had stable disease, indicating 56 advanced GIST cases (83.6%) obtaining clinical benefit. The OS rate was 91% in 1-year, 58% in 2-year, and 43% in 3-year. Conclusions The prognosis of high, and non-gastric and advanced GIST patients is poor. Radical resection combined with early imatinib treatment can improve the prognosis of GIST patients.

Objective To evaluate the impact of primary site, NIH risk and imatinib treatment on the prognosis of patients with gastrointestinal stromal tumors (GIST). Methods Clinicopathological data of 156 adult patients with GIST treated by imatinib in the Cancer Institute and Hospital of Tianjin Medical University from January 2006 to December 2010 were retrospectively analyzed. According to NIH risk classification, 30 patients were at moderate risk and 126 at high risk. Sixty-seven patients had advanced GIST. Prognosis of patients with different primary tumor site , different NIH risk and different treatment was compared respectively. Results Imatinib therapy was well tolerated in all the patients. Eighty-nine cases received radical operation and adjuvant imatinib treatment. Among 67 advanced GIST cases, 26 received radical operation and adjuvant imatinib treatment, 27 received palliative operation and adjuvant imatinib treatment, and 14 received simple adjuvant imatinib treatment without operation. All the patients had routine follow-up, ranging from 9 to 56 (median 27) months. The overall survival (OS) rate was 96% in 1-year, 86% in 2-year, and 71% in 3-year. The OS rate was 95% in 1-year, 77% in 2-year, and 65% in 3-year for patients at high risk, and all 100% in 1-, 2-, 3-year for patients at moderate risk, the differences was statistically significant (P=0.001). The OS rate was 97%in 1-year, 90% in 2-year, and 84% in 3-year for patients with gastric GIST, and 95% in 1-year, 69%in 2-year, and 52%in 3-year for patients with non-gastric GIST, the difference was significant(P=0.000). The OS rate was 98% in 1-year, 95% in 2-year, and 90% in 3-year for patients undergoing radical resection and adjuvant imatinib therapy. For 67 advanced GIST patients with imatinib therapy , none had complete remission, 41 had part remission, 15 had stable disease, indicating 56 advanced GIST cases (83.6%) obtaining clinical benefit. The OS rate was 91% in 1-year, 58% in 2-year, and 43% in 3-year. Conclusions The prognosis of high, and non-gastric and advanced GIST patients is poor. Radical resection combined with early imatinib treatment can improve the prognosis of GIST patients.

Objective To investigate the effects of electroacupuncture (EA) of different intensities on cerebral energy metabolism in a rat model of global cerebral ischemia-reperfusion (I/R) . Methods Forty male SD rats weighing 200-230 g were randomized into 5 groups ( n = 8 each) : group A sham operation; group B global cerebral I/R and C, D, E groups cerebral I/R+ 5, 3, 1 mA EA. Global cerebral I/R was induced by 4-vessel occlusion technique. Bilateral vertebral arteries were permanently occluded by cauterization.Bilateral common carotid arteries were clamped. When the bilateral pupils were completely dilated, the arteries were unclamped. Baihui,Mingmen and Zusanli were electrically stimulated with 5,3,1 mA (30-50 Hz) for 20 min at 1 h of reperfusion in C, D, E groups. The EA was repeated at 12 h of reperfusion. The animals were sacrificed at 24 h of reperfusion.The activities of Na+ -K+ -ATPase, succinodehydrogenase (SDH) and lactic dehydrogenase(LDH) in brain tissue were measured.Results Cerebral I/R significantly increased LDH activity and decreased Na+ -K+ -ATPase activity in group B as compared with group A. EA with 5 mA significantly decreased LDH activity and increased SDH and Na+ -K+ -ATPase activities in group C compared with group B. Conclusion EA can improve the cerebral energy metabolism in a rat model of global cerebral I/R and it is related to the intensity, which may be the mechanism by which EA reduces the global cerebral I/R injury.

Objective. The aim of this study was to detect coronary artery disease using99m Tc-MIBI myocardial perfusion imaging in patients with valvular disease.Methods. Thirty patients with valvular disease confirmed by echocardiography underwent 99mTc-MIBI myocardial perfusion imaging using multiSPECT 1h after stress test (exercise, dipyridamole or dobutamine test) and were performed coronary angiography within 1 month before valvular operation.Results.For 29 out of the 30 patients, the results of 99mTc-MIBI myocardial perfusion imaging were similar with those of coronary angiography, the concordance rate was 96.7% and the negative predictability was 100%.Conclusion.99m Tc-MIBI myocardial perfusion imaging is a reliable non-invasive method for detecting coronary artery disease in patients with valvular disease and so as to draw up suitable operation programs for them.

The purpose of the present experiment was to observe the morphological characteristics and invasiveness of a transplantable cancer NO 27 (U 27) after serial passages about 20 years. The results were as follows: The morphological characteristics of this tumor strain was low-differentiated carcinoma which were demonstrated by light microscopy and transmission electron microscopy. In the cytoplasm the single irregular distribution of the tensile fibrils and some semi-desmosome between adjacent cells were discovered by transmission electron microscopy. Two types of cancer cells were observed on the surface of the cancer nest by scanning electron microcopy:Ⅰ), There were many microvilli on the surface of the first type cancer cells; 2). The surface of the cancer cells of the second type were more flat sometimes with single small blebs. Many cancer cells had been released from cancer cell clump after 3 days of intramuscular implantation. Later they actively invaded into the spaces between muscle fibers in the form of amebae. Some cancer cells stretched out their filopodia directly in contact with target cells. The degenerative and atrophic changes of muscle tissue appeared in the invasive area of cancer cells. Finally these changes were leading to the disappearance of the entire structure of the muscle with the replacement by cancer tissues.

CNE cells were cultured on cover glasses placed in the culture flasks, and were examined under scanning electron microscope 6,24, 48,72, and 96 hours after cultivation. The results were as following: The surface structures of tumor cells changed in different intervals of cultivation. Evenly distributed zeiotic blebs were found on the surface of tumor cell after 24 hours of cultivation and most of these blebs were seen at marginal areas of tumor cells after 2 days of cultivation, and finally disappeared after 3 days of cultivation. In addition to the blebs some microvilli which had increased since the second day of cultivation were seen over the margin of tumor cells. On the third day of cultivation a large number of microvilli were seen distributed over the entire surface of tumor cells. Besides microvilli and zeiotie blebs, lamellipodia and ruffles were also observed after 24 hours, but vanished after 48 hours of cultivation. The filopodia were seen over the whole process of cultivation. They usually divided into 2、3 branches and the expanded ends looked like suckers. All these data indicated that the surface structure of tumor cells were variable in different periods of cultivation.