Objective:To investigate the clinical efficacy of conversion therapy with XELOX regimen in the treatment of stage IV advanced gastric cancer.Methods:The diagnosis and treatment process of two patients with stage IV gastric cancer who were diagnosed and treated in Southern Central Hospital of Yunnan Province (The First People's Hospital of Honghe State) in September 2018 and July 2019 were retrospectively analyzed. The performance of conversion therapy with XELOX regimen in the treatment of stage IV gastric cancer was analyzed based on relevant literature.Results:Pathological complete remission of stage IV gastric cancer was achieved in both patients after conversion therapy with XELOX regimen.Conclusion:Conversion therapy with XELOX regimen is effective on stage IV gastric cancer and is worthy of clinical promotion.

Rehabilitation medicine is one of the most important specialties in community health institutions. This article introduces the 12 year′s development of rehabilitation medicine in Fenglin Community Health Service Center, focusing on the talent allocation, service capabilities, resource expansion, basic facilities, personnel recruiting, department operating, service scope, and its achievements and influence, to provide reference for planning and construction of featured specialty in community health service centers.

Community health institutions have entered a new development stage of featured specialty construction. After 12 years of development, rehabilitation medicine now is the featured specialty of Fenglin Community Health Service Center. This article presents the train of thought and key points of specialty construction in primary care institutions based on the Fenglin′s experience. The positioning of featured specialty should be based on the community. The construction process should include 7 elements, namely, the standard operation procedure(SOP)of service system construction, the detailed publicity and implementation of the collaboration of specialists, prevention and control knowledge promotion for general practitioners, prevention and control knowledge education for community residents, service list, clinical efficacy evaluation, and clinical database. In the later iterations, the head of the department should always focus on the service system construction SOP and clinical database construction, and the rest parts can be assigned to the relevant team members.

OBJECTIVE: To analyze clinical features and genetic cause for a Chinese pedigree affected with microphthalmia. METHODS: The proband and his parents were subjected to whole exome sequencing (WES) to identify potential pathogenic variants. Sanger sequencing was carried out to confirm the result of WES in available members from the pedigree. Prenatal diagnosis was provided to the proband's mother by genetic testing of amnionic DNA. RESULTS: A heterozygous nonsense mutation c.289C>T (p.R97*) was identified in the OTX2 gene among three patients from the pedigree by WES. The result was confirmed by Sanger sequencing. The proband's mother has carried the same mutation but did not have microphthalmia. The proband's father, aunt and the mother's fetus did not carry the mutation. CONCLUSION The c.289C>T (p.R97*) mutation probably underlies the microphthalmia in this pedigree. Above result has facilitated genetic counseling and prenatal diagnosis.
China ; Female ; Humans ; Male ; Microphthalmos/genetics* ; Mutation ; Pedigree ; Pregnancy ; Prenatal Diagnosis ; Whole Exome Sequencing

OBJECTIVE: To explore the genetic basis for a fetus with cleft lip and palate. METHODS: Copy number variations (CNVs) in the fetus and his parents were detected with chromosomal microarray analysis (CMA). RESULTS: As revealed by the CMA assay, the fetus has carried a 228 kb deletion in Xp11.22 region and a 721 kb duplication in 9p21.1. Both CNVs were inherited from the parents. The CNV in Xp11.22 was predicted to be pathogenic by involving the PHF8 gene, whilst the CNV in 9p21.1 was predicted to be benign. CONCLUSION Deletion of the Xp11.22 region probably underlies the cleft lip and palate in this fetus.
Chromosome Deletion ; Chromosomes, Human, X ; genetics ; Cleft Lip ; diagnosis ; genetics ; Cleft Palate ; diagnosis ; genetics ; DNA Copy Number Variations ; Female ; Fetus ; Histone Demethylases ; Humans ; Microarray Analysis ; methods ; Pregnancy ; Prenatal Diagnosis ; Transcription Factors

Objective To Observe and evaluate the effect of hyperbaric oxygen therapy for patients with tracheotomy using ventilator lengthening tube. Methods 75 patients with tracheotomy in our hospital from January 2017 to January 2018 were divided into the study group (n = 38 cases) and the control group (n = 37 cases) according to the random number method. The control group used conventional oxygen inhalation while the study group used the ventilator tube after prolonged special oxygen hyperbaric oxygen pipe three (built-in ventilation pipe check valve) and bellows connecting an oxygen supply device, compared two groups of patients with oxygen inhalation methods suction phlegm oxygen concentration times and cabin, every time when treating. Results The rate of oxygen inhalation in the study group was 97. 37％ (37/38) higher than that of the control group (81. 08％ (30/37)), and the difference was statistically significant (P＜0. 05). The number of sputum sucking in the study group was (1. 02 ± 0. 36) times less than that of the control group (2. 32 ± 0. 53), and the difference was statistically significant (P＜0. 05). The total time of hospitalization in the study group was (16. 4 ± 2. 4) d, and the total time of hospitalization in the control group was (21. 7 ± 3. 2) d, the difference was statistically significant(WTBX〗P＜0. 05). The score of GCS in the study group was higher than that of the control group, and the difference was statistically significant (P＜0. 01). Conclusion The ventilator extension tube for hyperbaric oxygen therapy in patients with tracheotomy improves the oxygen concentration, ensures the curative effect, reduces the oxygen concentration in the cabin and reduces security risks; the operation method is safe, simple and practical and convenient for clinical application.

Objective To evaluate the effect of multidisciplinary intervention on antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.Methods By standardizing preoperative disinfection and surgical procedures, training and education of antimicrobial use, conducting quality control activities, and performing periodic feedback of supervised results, efficacy of improvement of antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection in a hospital was observed.Results In 2013 and 2014, incidences of surgical site infection(SSI) were 7.66%(17/222)and 6.80%(27/397) respectively,there was no significant difference between two groups(X2 =0.158,P>0.05).Prophylactic use of antimicrobial agents in surgical patients were as follows: cefuroxime(n=495), cefazolin(n=103), cefathiamidine(n=9), clindamycin(n=8), and cefotaxime(n=4), types of used antimicrobial agents were rational.In 2014, the implementation rate of necessary intra-operative antimicrobial adding was 95.02%, which was higher than 87.66% in 2013(X2=7.969,P<0.05), 30.73% of patients received antimicrobial prophylaxis for>48 hours, which was lower than 57.66% in 2013, difference was significant(X2=42.88,P<0.05).Conclusion Multi-intervention measures, including standard preoperative disinfection and surgical procedures, education and training, quality control circle, and feedback of supervised results can improve standard antimicrobial prophylaxis in neurosurgical patients undergoing craniotomy for tumor resection.

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound in breast precancerous lesions . Methods Retrospectively analyzed the contrast-enhanced ultrasound model and angiographic predictive model of 465 cases of the A prospective multicenter study of breast nodules contrast-enhanced ultrasound" that led the Sichuan Provincial People′s Hospital from January 2016 to April 2017 ,which included 69 cases of breast precancerous lesions and 396 other types benign lesions ,and the sensitivity ,specificity and accuracy of the diagnosis of breast precancerous lesions were calculated . Results The sensitivity of ultrasound predictive model for the diagnosis of precancerous lesions was 60 .9％ and AUC was 0 .681 . Precancerous lesions mainly showed non-concentricity , increased homogeneity , and increased lesions;other types of benign lesions mainly showed non-centripetal ,high uniformity enhancement and lesion size unchanged . Conclusions Contrast-enhanced ultrasound shows a potential value in the differential diagnosis of precancerous lesions and other types of benign lesions ,that can help clinicians to take early intervention measures for breast precancerous lesions ,but there are still many problems to be solved .

Objective] To sum up the clinical experience of professor Zhang Qin in treating menostaxis caused by PCSD. [Methods] From the TCM theory , therapy and successful case,it analyses the professor Zhang Qin's unique feature of PCSD.[Results] Professor Zhang considers that the disease is induced by the blades,which leads to blood stagnation-heat and Qi-deficiency,and puts forward the two-step traditional Chinese medicine: step one is to expel blood stasis using modified Jiawei Shixiaosan in the menstrual cycle from the first day to the fifth day ,step two is to stanch bleeding using modified Guchongtang in the menstrual cycle from the sixth day to the twelfth day. A case in point proves that two-step traditional Chinese medicine can recover the menstrual period normally. [Conclusion] Professor Zhang Qin's clinical experience in treating menostaxis caused by PCSD obtains the good curative effect,having enlightenment meaning to clinical practice,with promotion value.

Objective To evaluate the effect of comprehensive intervention on perioperative antimicrobial prophy-laxis in clean incision surgery in a hospital.Methods From 2011 ,clean incision surgery cases were performed com-prehensive intervention,antimicrobial use in 2011 -2013 were compared.Results A total of 5 945 cases of clean in-cision surgeries were investigated between 2011 and 2013,3 827 cases (64.37%)received prophylactic use of anti-microbial agents.Prophylactic antimicrobial usage rates in 2011 -2013 were 84.95%,69.99%,and 52.97% re-spectively(χ2 =380.94,P <0.001);the correct rates of medication time were 50.97%,79.99%,and 98.95% re-spectively(χ2 =827.02,P <0.001 );the percentages of prophylactic antimicrobial use ≤24 hours were 24.91 %, 39.96%,and 64.95% respectively(χ2 =422.55,P <0.001 );additional antimicrobial usage rates during surgery were 50.00%,60.00%,and 80.00% respectively(χ2 =59.47,P <0.001 ).Conclusion The implementation of comprehensive intervention measures can standardize antimicrobial use,reduce prophylactic antimicrobial usage rate,improve the correct rate of medication time,shorten the duration of antimicrobial use,and implement addition-al use of antimicrobial agents during surgery.