Objective:To study the genotyping and regional distribution characteristics of Yersinia pestis by single nucleotide polymorphism (SNP) in Gansu Province. Methods:A total of 52 strains of Yersinia pestis isolated from Himalaya Marmot plague foci and Spermophilus alaschanicus plague foci in Gansu Province from 1962 to 2017 were selected for culture and extraction of DNA. The genomic DNA of Yersinia pestis was sequenced by the second generation of Illumina PE150 to identify the SNP sites. The species characteristics of Yersinia pestis in Gansu Province was determined by the Kimura-2-parameter model of neighbor joining of Mega 10.0 software based on the SNP sites. The molecular evolutionary tree of the groups was determined by Hasegawa-Kishino-Yano model of maximum likelihood method according to the SNP sites. Results:A total of 103 SNP sites were identified in 52 strains of Yersinia pestis in Gansu Province, including 28 intergenic loci, 43 non-synonymous mutations, 31 synonymous mutations and 1 nonsense mutation. The 52 strains of Yersinia pestis were divided into 2 biotypes and 3 groups, which were ancient type (1.IN2, 3.ANT) and medieval type (2.MED). Among them, 35 strains belonged to 1.IN2 group, 13 strains belonged to 3.ANT group, and 4 strains belonged to 2.MED group. The 1.IN2 group was further divided into 5 subgroups: the groups of Yuerhong Town and Dangchengwan Town in Subei County, the groups of Mati Town and Dahe Town in Sunan County, and the group of Xiahe County. The 3.ANT group was further divided into 2 subgroups: the groups of Hongliuwan Town in Aksay County and Machang in Dangchengwan Town of Subei County. Conclusion:The SNP method can be used to genotype Yersinia pestis from different plague foci in Gansu Province, which has certain regional characteristics.

Objective:To understand the plague epidemic characteristics in the natural foci of the Qilian Mountains-A-erh-chin Mountains Himalayan marmot plague in Gansu Province, and to provide scientific basis for innovative prevention and control of the plague in combination with local conditions. Methods:A retrospective study was used to collect the monitoring data of the natural foci of plague in Gansu Province from 2011 to 2018 (from the epidemic surveillance files of the Center for Disease Control and Prevention of Gansu Province and direct network reporting information). Descriptive epidemiological method was used to analyze the plague epidemic characteristics of natural foci of the Qilian Mountains-A-erh-chin Mountains Himalayan marmot plague in Gansu Province from 2011 to 2018, including the distribution of host animals, pathogenic and serological testing of the plague bacteria, and the epidemic characteristics of human plague. Results:From 2011 to 2018, the total average marmot density in the natural foci of the Qilian Mountains-A-erh-chin Mountains Himalayan marmot plague in Gansu Province was 0.21/hm 2, of which Tianzhu County had the highest average marmot density of 0.58/hm 2, and Jiayuguan City had the lowest average marmot density of 0.01/hm 2. A total of 381 strains of Yersinia pestis were isolated in the foci, of which 4 were isolated from human corpses, 298 were host animals, and 79 were infectious vectors. Among them, the top 3 counties (cities) of isolated strains were Aksai County (38.85%, 148 strains), Subei County (31.50%, 120 strains) and Yumen City (16.27%, 62 strains). A total of 6 860 marmot serum, 1 769 dog serum were tested, the F1 antibody positive rates were 2.70% (185/6 860), 8.42% (149/1 769); and the F1 antigen positive rate of 814 animal materials was 4.30% (35/814), respectively. There were 4 times of human plague, 4 cases occurred and 4 cases died; 3 times occurred in Subei County and 1 time in Yumen City. The onset months were July, September, November and December. Active contact with infected animals such as shepherd dogs was the main route of infection, and migrant herders were the key occupation population. Conclusions:The animal epidemic situation in the natural foci of the Qilian Mountains-A-erh-chin Mountains Himalayan marmot plague in Gansu Province is active, and the plague presents different epidemic states in different regions. The prevention and control measures should be taken according to local conditions and guided by classification to strictly prevent the occurrence and transmission of the plague.

Objective:To study the clustered regularly interspaced short palindromic repeats (CRISPR) loci polymorphism of Yersinia pestis and its area distribution in Gansu province. Methods:A total of 203 strains of Yersinia pestis isolated from 1962 to 2014 were selected for the culture and extraction of DNA. Three pairs of CRISPR primers were used to amplify the strain DNA by PCR, and the PCR products were sequenced. The groups and genotypes of strains were determined according to the spacer and spacer arrangement of CRISPR loci in the strain. Cluster analysis was done by using the software BioNumerics 5.10. Results:A total of 16 spacers, including 9 species of YPa loci, 4 species of YPb loci and 3 species of YPc loci, were found in the 203 strains of Yersinia pestis. A new spacer of a1′ was found. The 203 strains were divided into 5 CRISPR genotypes and classified into 5 CRISPR clusters (Cb2, Ca7, Ca7′, CaΔ5′ and Ca35′). Each cluster showed significant area-specific characteristics, Cb2 was mainly distributed in Huining country and Pingchuan district, Ca7 was mainly found in Aksai Kazak autonomous country, Ca7′ was mainly found in Xiahe country, Ca35′ was mainly found in Subei Mongolia autonomous county and Yumen city and CaΔ5′ was mainly distributed in Sunan Yugur autonomous county. Conclusions:The strains from different plague foci in Gansu were distinguished by CRISPR, all kinds of clusters showed the obvious area specific characteristics. It is important to study the evolution of Yersinia pestis in Gansu and trace the molecular biology origin of human plague.

Objective:To evaluate the value of intraoperative magnetic resonance imaging (iMRI) combined with neuronavigation for the resection of insular gliomas.Methods:From August 2014 to October 2017 in the First Hospital Affiliated to Sun Yat-sen University,clinical data of 41 patients with insular glioma,who underwent the surgery assisted with 3.0T iMRI and neuronavigation,were analyzed retrospectively,and the resection extent,complications and prognosis were evaluated.Results:Subtotal tumor resection was achieved in 21 patients and partial resection was done in 20 after iMRI scanning.After further resection,total tumor resection was achieved in 16 patients,subtotal resection in 18 and partial resection in 7.There was a statistical significant difference in tumor resection between pre-iMRI and post-iMRI according to the Fisher test (P＜0.05).In the follow-up from 3 months to 3 years,the symptoms of the 41 patients had improved.Conclusion:iMRI corrected the shift of brain.Neuronavigation can accurately and timely assess the degree of resecting tumor.The combination of neuronavigation with surgery can maximally and safely resect insular glioma.

OBJECTIVETo explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.

METHODSAccording to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.

RESULTSThe duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).

CONCLUSIONSIn patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; drug therapy ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cyclophosphamide ; administration & dosage ; adverse effects ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Incidence ; Induction Chemotherapy ; Lung Neoplasms ; drug therapy ; Neutropenia ; chemically induced ; epidemiology ; prevention & control ; Polyethylene Glycols ; Recombinant Proteins ; administration & dosage ; Taxoids ; administration & dosage ; adverse effects

Female ; Gallbladder Neoplasms ; complications ; Humans ; Middle Aged ; Skin Neoplasms ; secondary

Objective To investigate the effect of ischemic preconditioning (IPC) on expression of intracellular adhesion molecule-1 (ICAM-1) in brain tissues following traumatic brain injury (TBI) in rats.Methods Sixty male SD rats weighing 220-250 g were randomly divided into three groups (n =20 for each):sham operation group,TBI group,and IPC group.Cerebral IPC models were induced by transient occlusion of the bilateral common carotid arteries; TBI models were induced by Feeney's freefalling method; rats in sham operation group were only performed exposure of dura of the right parietal lobe.Ten rats were sacrificed respectively at 6 and 72 hours after TBI and injured brain tissues were harvested to estimate wet/dry weight (W/D) ratio for the brain,determine ICAM-1 expression by immunohistochemistry and perform microscopic examination.Results Brain W/D ratio was significantly increased in TBI group compared with sham operation group (6 h:4.2 ± 0.4 vs 2.7 ± 0.4 ; 72 h:5.0 ±0.1 vs 3.1 ± 0.2,P ＜ 0.05).ICAM-1 expression was up-regulated in TBI group compared with sham operationgroup (6h:25.4±3.5vs8.6±1.3; 72 h:36.5±5.4 vs8.4±1.6,P＜0.05).W/D ratio was significantly decreased in IPC group compared with TBI group (6 h:3.5 ±0.6 vs 4.2 ±0.4; 72 h:3.7 ± 0.4 vs 5.0 ± 0.1,P ＜ 0.05).ICAM-1 expression was down-regulated in IPC group compared with TBI group (6 h:16.5 ± 2.7 vs 25.4 ± 3.5 ; 72 h:24.3 ± 4.6 vs 36.5 ± 5.4,P ＜ 0.05).Milder injury to brain tissues was observed in IPC group than in TBI group.Conclusion IPC can attenuate TBI in rats by down-regulating the expression of ICAM-1.

Objective To observe the efficacy of oral short-acting contraceptives after abortion surgery. Methods A to-tal of 200 cases who were voluntarily requested termination of pregnancy in our hospital were randomly divided into the observation group (100 cases) and the control group (100 cases). Antibiotics and Motherwort particles were given to the control group. Marvelon, antibiotics and Motherwort particles were given to the observation group after abortion. Thera-peutic effect of two groups was observed and compared. Results The observation group postoperative recovery was sig-nificantly better than the control group, the difference was statistically significant (P<0.05). The incidence of adverse reaction was significantly lower than that of the control group, the difference was statistically significant(P<0.05). Con-clusion Oral short-acting contraceptives after abortion surgery not only can promote postoperative recovery, reduce ad-verse reaction, beneficial to the women's physical and mental health.

Objective To evaluate the efficacy of clarithromycin (CAM) treatment in adult Chinese patients suffering from chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyps (CRSsNP).Methods A prospective,open and self-controlled clinical trial on patients with CRS was conducted.Fifty patients met inclusion criteria.Of 50 patients,there were 33 patients with CRSsNP and 17 patients with CRSwNP.CAM was administered at 250 mg/d and the duration of administration was 12 weeks.Outcome measures included assessments of visual analogue scale (VAS),the sino-nasal outcome test-20(SNOT-20),the medical outcomes study short-form 36 items (SF-36),Lunid-Kennedy endoscopy score,and Lund-Mackay computed tomography score.Before starting the treatment,2 months after treatment and at the end of treatment,each patient had to complete all the measures except Lund-Mackay computed tomography score,which was only conducted before and after treatment.In order to evaluate the safety of CAM,liver function and renal function in all patients were detected before and after treatment.SPSS 16.0 software was used to analyze the data.Results Forty-five patients completed 3 months follow-up and 5 patients withdrew due to different reasons.The results were as follows:(1) Thirty-three patients with CRSsNP's VAS scores of four time point were 5.81 ± 1.69,3.76 ± 1.94,2.98 ± 1.95,2.06 ±2.13,respectively,there were statistically significant improvements in turn (t values were 5.910,8.090,8.932,all P ＜0.05).Endoscopy score of four time point were 6.28 ± 1.28,5.O0 ± 1.67,4.12 ± 1.76,3.12 ±2.19,respectively,there were statistically significant improvements in tum compared with before treatment (t values were 6.662,9.161,9.936,all P ＜ 0.05).The CT scores before and after treatment were 10.33 ±4.65 and 4.67 ±4.59,respectively(t =7.226,P =0.000).(2) Seventeen patients with CRSwNP's VAS scores of four time point were 6.07 ± 2.02,4.87 ± 2.61,4.06 ± 2.85,4.08 ± 2.80,respectively,there were statistically significant improvements after 2 or 3 months (t values were 3.285,3.468,both P ＜ 0.05) except after one month (t =1.846,P ＞ 0.05).Endoscopy score of four time point were 10.65 ±1.77,9.35 ± 1.93,8.65 ± 2.76,8.47 ± 2.76,respectively,there were statistically significant improvements in turn(t values were 4.068,4.863,5.156,all P ＜0.05).The CT scores before and after treatment were 13.82 ± 4.94 and 11.41 ± 5.12,respectively (t =3.975,P =0.001).(3) During the period of CAM treatment,1 patient reported a tolerable headache and weakness and 1 patient had abdominal pain after two months treatment,all the symptoms disappeared while they were asked to stop the drug.Liver function and renal function were detected in 40 patients,the differences before and after treatment were not significant statistically.Conclusions Long-term,low-dose CAM treatment is effective in the treatment of CRSsNP and CRSwNP in Chinese patients.Meanwhile,the efficacy of CAM is more significant in polyp-free group compared with polyp group.Low does CAM therapy is safe,and the liver function and renal function does not worsen after 3 months treatment.