Volume 94  ·   Issue 08  ·  2014

Helicobacter pylori (H. pylori) is a micro-aerobic gram-negative spiral bacterium that is infected with about 50% of the world's population.H. pyloriInfection is an important cause of chronic gastritis, peptic ulcer, gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. Therefore,H. pyloriEradication therapy has become the recommended treatment in the global guidelines for the above diseases in clinical practice. At present, at home and abroadH. pyloriEradication therapy mostly uses triple or quadruple therapy of proton pump inhibitor (PPI) and/or bismuth combined with two antibiotics. Commonly used antibiotics include clarithromycin, amoxicillin, quinolones, furazolidone, metronidazole, etc. However, in widespread eradicationH. pyloriWhile treating,H. pyloriResistance to antibiotics is increasing, leading to a gradual decline in eradication rates^[1]。 Previously, scholars have also been exploring personalized triple or quadruple therapy through bacterial culture and drug sensitivity testing. butH. pyloriThe culture is difficult and the culture period is too long, so this method is difficult to be applied in clinical practice, which also makes the domesticH. pyloriThe rate of drug resistance is increasing. Therefore, the newH. pyloriThe establishment of drug resistance testing methods is important forH. pyloriEradication treatment is particularly important.

To compare the efficacies of non-bismuth quadruple therapy for 7 days versus standard triple therapy for 7 or 10 days in initial treatment of Helicobacter pylori(H.pylori).

A randomized, open-labeled, controlled trial comparing non-bismuth quadruple therapy with standard triple therapy was performed at Peking University First Hospital from August 2010 to July 2012.A total of 246 patients with a diagnosis of H. pylori infection by ¹³C-urea breath test and receiving no eradication therapy were randomly divided into non-bismuth quadruple therapy and standard triple therapy for 7 or 10 days.There were 110 males and 136 females with an age range of 18-75 years.Among them, 81 patients received non-bismuth quadruple therapy (esomeprazole 20 mg, amoxicillin 1 000 mg, clarithromycin 500 mg and tinidazole 500 mg given twice daily for 7 days); 82 standard triple therapy(esomeprazole 20 mg, amoxicillin 1 000 mg and clarithromycin 500 mg given twice daily)for 7 days and 83 standard triple therapy for 10 days.The efficacies were examined at Week 4 post-therapy by ¹³C-urea breath test.The incidence of adverse drug reactions was recorded.

Among them, 242 patients completed the follow-up.The eradication rates for non-bismuth quadruple therapy and standard triple therapy for 7 or 10 days were 91.4% (74/81), 79.3% (65/82) and 79.5% (66/83) as determined by intention-to-treat analysis (ITT). The eradication rates were 92.5% (74/80), 81.3% (65/80) and 80.5% (66/82) respectively as determined by per-protocol analysis (PP). Non-bismuth quadruple therapy was superior to standard triple therapy for 7 days (ITT analysis P=0.029, PP analysis P=0.035) and 10 days (ITT analysis P=0.032, PP analysis P=0.026). The differences for the eradication rates between standard triple therapy for 7 days and for 10 days were insignificant (ITT analysis P=0.968, PP analysis P=0.902): Adverse reaction rates for non-bismuth quadruple therapy (8.8%, 7/80) and standard triple therapy for 7 days (7.5%, 6/80) and 10 days (9.8%, 8/82) were not significantly different (P=0.872).

Non-bismuth quadruple therapy for 7 days is both effective and safe for the first-line eradication of H. pylori.

To explore the eradication efficacies of triple versus quadruple furazolidone-based regimens for Helicobacter pylori (H. pylori) infection.

A total of 357 outpatients with H. pylori infection were enrolled from June to December 2010. There were 200 males and 157 females with an average age of(42±12)years. A diagnosis of duodenal ulcer was made according to their endoscopic examination results. They were randomly assigned into 4 treatment groups: 7-day triple (n=89) and 10-day triple (n=91), rabeprazole 10 mg, amoxicillin 1 000 mg and furazolidone 100 mg twice daily for 7 and 10 days respectively. 7-day quadruple (n=88) and 10-day quadruple (n=89), rabeprazole 10 mg, bismuth 220 mg, amoxicillin 1 000 mg and furazolidone 100 mg twice daily for 7 and 10 days respectively.H. pylori status was re-assessed with ¹⁴C-urea breath test after 4-week therapy.

Among them, 323 cases completed the study. According to the analysis of intention-to-treat (ITT), the H. pylpori eradication rates were 71.91%(64/89) in 7-day triple, 81.32%(74/91) in 10-day triple, 78.41%(69/88) in 7-day quadruple and 83.15% (74/89) in 10-day quadruple groups. No significant deviation existed among all groups (P>0.05). According the per-protocol (PP) analysis,H. pylori eradication rates were 78.05%(64/82)in 7-day triple, 88.10%(74/84) in 10-day triple, 87.34%(69/79) in 7-day quadruple and 94.87% (74/78) in 10-day quadruple groups. Significant deviation existed among all groups (P=0.017). The H. pylori eradication rate in 10-day quadruple group was significantly higher than that in 7-day triple group (P=0.002). The total adverse reaction rate was 7.00% (25/357). No significant difference existed among all groups (P>0.05).

Quadruple treatments provide higher H. pylori eradication rates than triple therapies. A 10-day treatment may improve H. pylori eradication rate. And 10-day quadruple regimen with furazolidone and bismuth may be effective for H. pylori infection.

To evaluate the efficacy, compliance and adverse effects of 14-day amoxicillin and furazolidone-based quadruple regimen as rescue treatment for Helicobacter pylori (H.pylori) infection.

A total of 228 patients positive for H. pylori with previous failed treatment at least once were enrolled into this retrospective study.There were 71 males and 157 females, aged (50±13) years. A 14-day quadruple regimen was administered along with furazolidone, amoxicillin and bismuth citrate in combination with proton pump inhibitors.Adverse effects were recorded at the end of treatment.H.pylori status was assessed by ¹³C-urea breath test at 4 weeks after treatment.

Among them, 206 patients completed treatment.The H. pylori eradication rates were 91.96%(206/224)and 90.35%(206/228)according to per-protocol (PP) and intention-to-treat (ITT) analyses respectively.Mild and moderate adverse effects such as dizziness, nausea and diarrhea occurred in 43 patients(18.86%). Four of them had to terminate their treatment due to rash, dizziness and headache respectively.

The 14-day quadruple therapy with furazolidone, amoxicillin, bismuth citrate and proton pump inhibitors may be an effective regimen for rescue treatment because of its relatively high eradication rate (>90%). The patients should be watched closely during the treatment since the adverse effects of this regimen happen frequently.Treatment is stopped in events of skin rash, fever or other serious adverse effects.Vitamins B₁ and B₆ can relieve some discomforts.

To explore the antibiotic resistance of Helicobacter pylori (H.pylori ) in children and identify 23 S rRNA gene mutations in macrolide-resistant strains.

From December 2008 to December 2010, a total of 73 H. pylori strains were isolated from 120 gastric mucosa specimens obtained from children of gastrointestinal symptoms with a diagnosis of gastritis or peptic ulcer underwent gastroscopy.The antibiotic resistance to 9 antibiotics of 73 H. pylori strains isolated from gastric biopsies was detected by E-test method.Mutations in 23 S rRNA gene of macrolide-resistant of isolated H. pylori strains were examined by polymerase chain reaction (PCR).

Seventy-three H. pylori strains (60.8%) were isolated from gastric biopsies.Seventy were drug resistance strains and only 3 sensitive strains.No resistance to amoxicillin, gentamicin and tetracycline was observed.The resistance rate to azithromycin, clarithromycin, metronidazole, rifampicin, levofloxacin and moxifloxacin was 79.5%(58/73), 80.8%(59/73), 58.9%(43/73), 6.8%(5/73), 12.3%(9/73) and 13.7%(10/73) respectively.The dual, triple and quadruple antibacterial resistant percentage was 47.9%(35/73), 8.2%(6/73)and 1.4%(1/73)respectively.And the multi-drug resistance rate to clarithromycin, azithromycin and metronidazole was 43.8%(32/73). The gene mutation rate of A2142C, A2142G, and A2143G in 23 S rRNA gene was1.6%(1/64), 6.3%(4/64)and 85.9%(55/64)respectively.

There is a high rate of multi-drug resistance to clarithromycin, azithromycin and metronidazole in H. pylori strains isolated from children at our hospital.Therefore amoxicillin and rifampicin sensitive to H. pylori strains should be considered for H. pylori eradication.A2143G is the most populated mutation in macrolide-resistant strains.

To explore the impact of insertion timing of iodophor cotton ball on the control of infection complications after transrectal ultrasound (TRUS) guided prostate biopsy.

A total of 197 patients undergoing TRUS-guided prostate biopsy from March 2012 to January 2013 were randomly divided into post-discharge, pre-discharge and pre-discharge plus post-discharge groups. A prospective study was made on the symptoms of infections, signs and relevant laboratory examinations in all three groups.

Infections occurred in 6/66 patients in the post-discharge group and 2 patients in the other two groups. The prevalence rates were 7.58%, 3.08% and 3.03% respectively. Statistically significant difference existed in the prevalence rate between pre-discharge and post-discharge groups(P<0.05). Yet no statistically significant difference existed between pre-discharge and pre-discharge plus post-discharge groups(P>0.05).

During the TRUS guided prostate biopsy, inserting an iodophor cotton ball before placing an ultrasonic probento the rectum can control the infection and reduce its prevalence rate.

To explore the serotypic distribution and ompA gene variations of Chlamydia trachomatis(C.trachomatis)of male reproductive tract at our hospital.

A total of 399 samples of reproductive tract secretion were collected from urinary outpatient with suspected C. trachomatis infection of genital tract from December 2011 to March 2013 and screened by C. trachomatis detection kit.Amplificated by nested PCR and sequenced of C. trachomatis ompA gene after screening positive samples.Sequencing products were typed by BLAST of PubMed and MegAlign program of DNAstar software to compare the clinical isolates of C. trachomatis ompA gene with the standard sequence.And various serotypes of C. trachomatis ompA gene mutation were analyzed.

C. trachomatis was detected with a positive rate of 14.8% (59/399). All ompA genes of 59 C. trachomatis positive specimens were successfully amplified and serotyped.The types were E (n=17, 28.8%), F (n=16, 27.1%), D (n=13, 22.0%), G (n=5, 8.5%), H (n=3, 5.1%), K (n=3, 5.1%) and J (n=2, 3.4%). The most mutations of ompA gene of C. trachomatis in clinical specimens were serotype D(n=9), followed by serotype G(n=5).

The distribution of serotypes in male patients is serotypes E, F, D-type dominant.The serotype D of C. trachomatis is variation up.

To explore the clinical charectristic of adult hereditary spherocytosis (HS) and the efficacies of splenectomy.

Six cases with adult HS were collected from July 2006 to July 2012.And their clinical features, laboratory profile and treatment were retrospectively analyzed.

There were 2 males and 4 females with a diagnostic age of 21-67 years.Their chief complaints were symptoms of upper gastrointestinal tract.The characteristic tetralogy was anemia, hemolysis, splenomegaly and gallstone.Familial inheritance pattern was found in 2 patients.The laboratory examination results demonstrated anemia, reticulocyte and elevated indirect bilirubin in 6 patients.Three patients had positive urobilinogen.The osmotic fragility(OF)test were 2 positive and 4 negative ones.And 2 negatives turned positive after incubation.The acidified glycerol lysis test (AGLT50) was positive in all.Ultrasonography showed splenomegaly and gallstone.There were 3 abnormal types red cells in peripheral blood, densely-dyed red cells(35%-89%), microspherocyte (14%-20%)and irregular-shaped red cells.Scanning electron microscope showed single or many acanthocytes or spikes in red cell surface.Red cell body was irregular dish or flower-shaped.Biconcave disc shape disappearanced.Three patients had short bands 3, 4.1 or 4.2.The age of onset was late and clinical symptoms was lighter.Spectrin-ankyrin was deficient for another 2 patients.The age of onset was early and clinical sign serious.Splenectomy and cholecystectomy were performed in 3 patients.Their postoperative hemoglobin was normal during follow-ups.Clinical relief was achieved.

Combined experiments can enhance the diagnostic rate of adult HS so as to avoid misdiagnosis.And the efficacies of splenectomy are definite.

To improve the clinicopathological understanding of blastic plasmacytoid dendritic cell neoplasm (BPDCN).

A total of 7 BPDCN patients were recruited from 2009 to 2013.And their clinicopathological and immunohistological features, treatment and prognosis were retrospectively analyzed.

There were 6 males and 1 female.The median age range was 60 (6-72) years at the time of diagnosis.The skin lesion at the time of diagnosis presented as generalized (n=6) or solitary (n=1) plaques or nodules.Histologic examination showed a diffuse or nodular infiltrate composed of intermediate-sized cells in dermis sparing epidermis area.The tumor cells contained round to ovoid nucleus, finely dispersed chromatin and 1 or 2 small-sized nucleoli.Most neoplastic cells were positive for CD4, CD56 and CD123 while negative for CD3, CD20, CD30, CD34, CD79a, MPO and EBER.Two patients received chemotherapy.One had no response while another relapsed rapidly.Two patients had a spontaneous regression of skin lesions and one died 2 years later.And no systematic infiltration was detected at diagnosis.

BPDCN is a rare hematopoietic malignancy with specific immunophenotypes.It primarily affects elderly males and frequently presents initially as cutaneous involvement.It may be easily misdiagnosed and has a rapid course and a poor prognosis.

To detect the serum protein expressions of histone deacetylase 1 (HDAC1) and DNA methyltransferase 1 (DNMT1) in patients with non-small-cell lung cancer and explore the correlation between their expressions and clinicopathological features.

Enzyme-linked immunosorbent assay (ELISA) was used to measure the protein expressions of HDAC1 and DNMT1 in 136 lung cancer patients hospitalized at Department of Respiratory Diseases, First Affiliated Hospital, Zhengzhou University from September 2012 to June 2013 (cancer group). And 147 healthy physical examination subjects from Sixth People′s Hospital of Zhengzhou were selected as controls and their clinicopathological features analyzed.

The protein expressions of HDAC1 and DNMT1 in patients with lung cancer (145±53, 50±11) were higher than those in control group (78±56, 27±6). And there was statistical significance(t=596.16, 152.64, both P=0.000). The protein expressions of HDAC1 and DNMT1 were correlated with gender, smoking history and age (among P<0.05). There was a positive association between the protein expressions of HDAC1 and DNMT1 in non-small-cell lung cancer (r=0.525, P=0.000). Statistical significance existed between the protein expressions of HDAC1 and DNMT1 and histological types or different stages (all P<0.01).

The higher protein expressions of HDAC1 and DNMT1 may play an important role in the early process of lung cancer.

To explore the relationship between metabolic diseases and death from all causes and cardiovascular diseases (CVD) in elderly male diabetics.

A total of 681 elderly male diabetics were recruited from June 1997 to June 1999 and followed up for 10 years. All underwent regular check-ups in PLA General Hospital each year. The Cox proportional hazards model was applied to the multivariate survival analysis for all-cause and CVD mortality. And the cumulative survival rates were calculated by Kaplan-Meier method and log-rank test was used to compare the survival rates.

During a 10-year follow-up, 208 subjects died, including 70 deaths from CVD. Multivariate Cox regression analysis showed that age [relative risk (RR)=1.099, 95% confidence interval (CI)1.076-1.123], pulse pressure(RR=1.009, 95%CI 1.001-1.017), elevated postprandial glucose level(RR=1.115, 95%CI 1.075-1.157)and lower triglyceride(RR=0.683, 95%CI 0.539-0.865)and high-density lipoprotein cholesterol(RR=0.444, 95%CI 0.257-0.766)increased the risks of all-cause mortality while age(RR=1.112, 95%CI 1.070-1.155), elevated postprandial glucose level(RR=1.278, 95%CI 1.170-1.396)and systolic blood pressure(RR=1.013, 95%CI 1.002-1.024)increased the risks of CVD mortality. The cumulative survival rates from CVD mortality in diabetics with metabolic syndrome were significantly lower compared with those with diabetes only(P<0.01).

CVD remains a main cause of death for Chinese elderly male diabetics. Advanced age and elevated postprandial glucose level are risk factors of all-cause and CVD mortality. Diabetes mellitus with concurrent hypertension or metabolic syndrome is associated with an increased risk of CVD death.

To summarize the characteristics of etiological distribution of adrenal incidentaloma during the past 20 years.

All the relevant data of adrenal incidentaloma patients admitted into Chinese PLA General Hospital between January 1993 and January 2013 were collected. Their gender ratio, visiting ages and final diagnoses were retrospectively analyzed.

There were 1 173 patients were collected, of which, 629 (53.62%) males and 544 (46.38%) females with a mean age of (50.84±12.13) years. There were 669 (57.03%) hypertensive cases and 622 cases undergone adrenalectomy. Routine medical checkup and abdominal discomfort led to the discovery of adrenal incidentalomas. As to the etiologies, there were non-functional tumors (n=809, 68.97%), pheochromocytoma (n=137, 11.68%), primary aldosteronism (n=84, 7.16%) and adrenal Cushing syndrome (n=65, 5.54%). The proportions of adrenal cortical carcinomas and metastases were 1.70% (n=20) and 1.36% (n=16) respectively. Compared with normotension group, the proportion of non-functional lesions in hypertension group was significant lower (73.81% vs 65.32%, P<0.05) while the proportions of primary aldosteronism and adrenal Cushing syndrome were higher (11.96% vs 0.79%, 5.83% vs 5.18%, bothP<0.05).

Adrenal incidentaloma patients with concurrent hypentension is quite common. In respect of etiologies, non-functional tumor is the most common and followed by pheochromocytoma and primary aldosteronism Cushing syndrome.

To explore the efficacies of neoadjuvant chemotherapy plus nutritional supports for gastric cancer complicated with pyloric obstruction.

Retrospective analyses were performed for a total of 116 patients of gastric cancer complicated with pyloric obstruction undergoing exploratory laparotomy from January 2004 to June 2013.

Sixty-two patients (group A) received neoadjuvant chemotherapy (regimen of FOLFOX) plus preoperative nutritional support.And parenteral (PN, n=30) and enteral (EN, n=32) nutritional supports were provided.Another 54 patients (group B) underwent exploratory laparotomy alone.The serum level of albumin and score of quality of life in group A at the last preoperative day improved significantly.And EN was better than PN.The rate of excision/radical excision of group A (85.5%, 45.2%) was much higher than group B (64.8%, 18.5%) (both P<0.05).

Nutritional support, especially EN, can improve the nutritional status and quality of life in patients with gastric cancer complicated with pyloric obstruction.And nutritional support plus neoadjuvant chemotherapy increase the rate of tumor excision.

To explore the efficacies and toxicities of different platinum-based combination chemotherapeutic regiments for patients with advanced non-small cell lung cancer (NSCLC).

A total of 239 advanced NSCLC from January 2011 to December 2012 were reviewed in Xinqiao Hospital.The chemotherapeutic efficacies and adverse effects in the first-line treatment of advanced NSCLC by paclitaxel plus platinum (paclitaxel group, n=113), gemcitabine plus platinum (gemcitabine group, n=72) and docetaxel plus platinum (docetaxel group, n=54) regiments were retrospectively analyzed and compared.Their efficacies and toxicities were analyzed by Chi-square test.And survival was estimated with Kaplan-Meier method.

The objective response rate (ORR) of three groups were 42.5%, 43.1% and 35.2% respectively (P=0.612). The disease control rate (DCR) were 84.1%, 75.0% and 74.1% respectively (P=0.198). The median progression-free survival was 5.6, 5.8 and 3.2 months respectively (P=0.000). The major adverse effects were myelosuppression, gastrointestinal reaction, alopecia and neurotoxicity, etc.The incidence rate of neurotoxicity among three groups were 34.5% (39/113), 11.1% (8/72) and 18.5% (10/54) respectively (P=0.001). No significant inter-group difference of adverse effects existed (all P>0.05), except for neurotoxicity.

Three platinum-based combination chemotherapeutic regiments produce excellent efficacies with acceptable adverse effects.Their ORR and DCR were similar.And the median progression-free survival of paclitaxel and gemcitabine groups is significantly longer than that of docetaxel group.

To explore the therapeutic effects and mechanism of Bacillus Calmette-Guerin (BCG) vaccine on airway remodeling in rats.

Forty male Wistar rats were randomly divided into 5 groups of control, asthma, BCG vaccine, dexamethasone and BCG vaccine plus dexamethasone (n=8 each). The animals were then sensitized and challenged by ovalbumin to establish the asthmatic model.A subcutaneous injection of BCG vaccine 0.025 mg was administered for the BCG vaccine group and an intraperitoneal injection of dexamethasone 0.5 mg/kg for the dexamethasone group.In BCG vaccine plus dexamethasone group, the rats received a subcutaneous injection of BCG vaccine (0.025 mg) plus an intraperitoneal injection of dexamethasone (0.25 mg/kg). All treatments were offered at half an hour pre-atomization.The control rats received an aerosol inhalation of normal saline instead of ovalbum.The parameters of airway morphological changes and the degree of airway remodeling were analyzed with computer graphics.The levels of transforming growth factor beta 1 (TGF-β₁ ) in bronchoalveolar lavage fluid (BALF) and the expressions of E-cadherin, α-smooth muscle actin (α-SMA) and fibronectin in lung tissue and sera were detected.

In asthmatic rats, the thickness of airway wall and smooth muscle were more significant than those of the control group ((95.01±0.48), (43.86±0.51) vs (25.96±0.42), (15.14±0.18) μm). Compared with the control group, the levels of TGF-β ₁ in BALF and sera were significantly higher ((10.05±0.26), (75.67±1.17) vs (1.53±0.18), (22.24±0.35) μg/L), the expression of E-cadherin significantly decreased (0.26±0.03 vs 0.45±0.04), while α-SMA and fibronectin significantly increased (0.54±0.06, 0.56±0.06 vs 0.32±0.04, 0.35±0.06) (all P<0.01); Notably, compared with the asthmatic group, the thickness of airway wall and smooth muscle ((58.46±2.43), (49.51±1.44), (49.63±1.42) and (25.84±0.54), (25.44±0.40), (25.62±1.17) μm) significantly decreased by the treatments of BCG vaccine, dexamethasone or BCG vaccine plus dexamethasone, the levels of TGF-β₁ in BALF and sera ((3.42±0.18), (3.27±0.34), (3.39±0.26) and (37.61±0.22), (35.65±0.49), (36.22±0.71) μg/L) significantly decreased, the expressions of E-cadherin (0.29±0.04, 0.32±0.04, 0.31±0.03) significantly increased and α-SMA and fibronectin (0.40±0.06, 0.35±0.06, 0.40±0.05 and 0.47±0.03, 0.43±0.06, 0.47±0.04) significantly declined (all P<0.01). Western blot showed the similar results.

BCG vaccine alleviates airway epithelial cell injury and epithelial mesenchymal transition induced by TGF-β₁ through immunoregulation.It also reduces asthmatic airway remodeling with a combination of dexamethasone.

To explore the effects of autophagy on 5-fluorouracil (5-FU) cytotoxicity for gallbladder carcinoma GBC-SD cell and discuss a novel and promising strategy of autophagy inhibitor for increasing the clinical efficacy of 5-FU in the treatment of gallbladder carcinoma.

After a pre-treatment of autophagy inhibitors, such as chloroquine (CQ) and 3-methyladenine (3-MA), or silencing the autophagy-related genes (autophagy-related gene 5, autophagy-related gene 7), the inhibition of 5-FU to proliferation and the viability of GBC-SD cell were measured.And the apoptotic rate and cell cycle of GBC-SD cell were analyzed.

Blocking of autophagy by pharmacological (CQ, 3-MA) or genetic (siRNA) means induced cell death in GBC-SD cell pre-treated with 5-FU.Furthermore, 5-FU treatment resulted in a general increase of apoptotic rate and G0/G1 arrest of GBC cells.And such an effect was potentiated by a pre-treatment of CQ.

Autophagy in GBC-SD cell is induced by DNA damaging agent 5-fluorouracil.While in combination with CQ pre-treatment, the cytotoxicity of 5-fluorouracil becomes potentiated.

Academic exchange and academic discussion are indispensable to promote the development of science and technology^[1]。 Through various forms of academic exchanges and scientific and technological cooperation, the academic conference will timely transmit the research trends and information of the academic frontiers to scientific researchers, broaden the scientific research horizons of the vast number of scientific researchers, create a good academic atmosphere and environment, promote the training and construction of talents, and enhance the scientific research academic status of the unit^[2,3]。 Information feedback is an essential link in the process of information dissemination^[4]。 In the organization and management of academic activities, we should introduce information feedback mechanism to improve the organization and management of the conference and improve the effectiveness of the conference^[5]。 The incidence and prevalence of traumatic diseases and skeletal degenerative diseases are high in China^[6]The number of orthopedic surgeons is huge, but the clinical work of orthopedic surgeons is relatively tight. Therefore, the academic conference of orthopedics is very important for the academic exchange of clinicians, nursing staff and basic researchers in the field of orthopedics, but different people may have different needs for the conference. How effective the orthopedic academic conference will be for different populations is unknown. It is necessary to establish an evaluation feedback mechanism for large academic conferences to provide recommendations for holding more efficient academic conferences. The purpose of this study was to evaluate the effect of participants with different characteristics on the annual academic conference of orthopedics through a cross-sectional survey, and to provide data support for measures to improve the satisfaction of the academic conference.

There are trillions of microorganisms living in and on the surface of the human body. About 90% of the cells in the human body are microbial cells, and the remaining 10% are human cells. Therefore, in a sense, the human body is a complex composed of many species. The concept of microbiota has broken the previous cognition mode that some pathogenic bacteria directly cause diseases. More and more evidence shows that intestinal microorganisms play an important role in the occurrence and development of many diseases. Recently, the role of microecological preparations in the treatment of inflammatory bowel disease (IBD) has gradually become a research hotspot. With the rise of human metagenomics, people's understanding of the structure and function of human genome, the relationship between human genome and microbial genome, the law of action and the relationship with disease has entered a new era.

Memory consolidation can stabilize and strengthen memory. The process of stabilization largely occurs in the waking state^[1]。 The reinforcement process is mainly performed during sleep, and this reinforcement involves restoring memories that were once lost^[2]Or new learning occurs^[3]This process is also referred to as "offline" memory consolidation. The study of sleep-dependent memory consolidation focuses on the influence of learning material, learning, test-retest, post-learning sleep and the characteristics of subjects on memory consolidation^[4]。 Existing mental schemas affect memory consolidation^[5]This kind of research is often conducted from the systemic and molecular levels of memory consolidation. From an applied perspective, we are concerned about the ability to improve the level of memory consolidation through human intervention, especially the selective reinforcement of certain memories. These studies may dramatically change the way humans learn and live. The research results of the past ten years are summarized as follows.

acute kidney injury (AKI) refers to the rapid decline of renal function in a short period of time due to various reasons. The latest Organization for Improving the Global Prognosis of Kidney Disease (KDIGO) is defined as an increase in serum creatinine ≥26.5 μ mol/L within 48 h or an increase in serum creatinine ≥1.5 times the basal level within 1 week, or urine output<0.5 ml·kg^－1• h^－1After more than 6 h, AKI can be diagnosed if one of the above 3 criteria is met^[1]。 AKI can also occur on the basis of the original chronic kidney disease (CKD). The etiology is mostly related to surgery, trauma, poisons, drugs (especially contrast agents, antibiotics, chemotherapy drugs and non-steroidal antipyretic and analgesics, etc.) and sudden disastrous events. It is a common critical disease involving various clinical departments. The results of domestic and foreign studies show that the incidence of AKI is 3% ~10% in general hospitals and 30% ~60% in intensive care units. The mortality rate of critically ill AKI patients is as high as 30% ~80%^[1,2,3,4]The prevention and control situation is very severe. AKI has been considered clinically reversible in the past. If the renal function of patients returns to normal after treatment, the long-term prognosis is good. In recent years, studies have shown that as long as AKI occurs, it will not only significantly increase the short-term mortality of patients^[5,6,7,8]Whether or not renal function recovers, it may adversely affect the long-term prognosis of patients (including long-term survival, incidence of chronic kidney disease, and incidence of cardiac insufficiency^{[9,10,11,12,13,14,15,16]}。 This article summarizes the recent progress of AKI on the long-term prognosis of patients as follows.

Malignant lymphomas in which MYC and BCL2 translocate simultaneously are called double-hit lymphomas (DHL). Gene translocations can also occur in BCL6, CCND1, BCL3 and other genes. BCL2 and MYC gene translocations are the most common, accounting for about 62% of all DHL^[1]。 The 2008 World Health Organization (WHO) classification classified DHL as unclassifiable B-cell lymphoma (BCLU) with morphological, immunophenotypic and other characteristics between diffuse large B-cell lymphoma (DLBCL) and Burkitt's lymphoma (BL)^[2]。 Although the incidence of DHL is low, accounting for only about 2% of B-cell lymphomas^[3]However, its clinical behavior is highly aggressive and the chemotherapy effect is poor, so strengthening the understanding of DHL plays an important role in the diagnosis and treatment of lymphoma.

The chemotherapy of drug-resistant tuberculosis, especially multidrug-resistant tuberculosis (MDR-TB), still does not achieve satisfactory results, and the adverse reactions are large, and the treatment cost is high^[1,2]It is a major infectious disease that threatens human health and has become an urgent problem to be solved in the control of tuberculosis. In recent years, some progress has been made in the research of chemotherapy regimens for drug-resistant tuberculosis, which are summarized as follows.

A 26-year-old female presented to the clinic on June 25, 2011 due to painless, intermittent macroscopic hematuria for 1 month without obvious trigger. In the past, he was in good health and had no symptoms such as frequent urination, urgency, painful urination and low back pain. Physical examination at admission: No obvious mass was palpable in the abdomen, and mild percussion pain in the right kidney area. Laboratory tests: positive urine turbidity (+ +), urine protein (+ +), urine occult blood (+ +). B-ultrasound showed that a solid 40 mm ×30 mm occupied space was seen in the upper pole of the right kidney, and the internal echo was more uniform and the boundary was clearer. CT showed that a substantial mass occupying a 39 mm ×28 mm slightly high-density shadow was seen at the upper pole of the right kidney. After enhanced scan, the mass was slightly enhanced, and the bilateral common iliac artery, external iliac artery, abdominal aorta, both renal arteries and both renal veins showed good results. On June 29th, he underwent radical resection of open right kidney tumor under general anesthesia and was sent for pathological examination. Gross: A mass with a diameter of 39 mm can be seen 10 mm below the capsule of the upper pole of the kidney, and the boundary with the surrounding kidney tissue is clear. HE morphological characteristics: The tumor cells are mainly papillary (FIG. 1A) and acinar (FIG. 1B) Two arrangements, hemorrhage can be seen in the acinar structure in some areas, similar to clear cell renal cell carcinoma; The tumor cells are round or polygonal, with abundant cytoplasm, translucent or eosinophilic staining. The nucleus is rounded in the center, and the nucleolus can be seen, and the interstitium can be seen with gravel formation (Figure 1C), mitotic elephants are rare. Immunohistochemistry: Transcription factor E3 (TFE-3) (Figure 2) and CD10 were all diffuse (+), P504S (focus +), and the rest of CK, CK7, 34 β E12, EMA, vimentin, HMB45, SMA were all (-). Pathological diagnosis: (Right kidney) Xp11.2 translocation/TFE-3 gene fusion associated renal carcinoma with ipsilateral regional lymph node metastasis (1/2). The patient did not receive adjuvant therapy after surgery, and the patient was generally in good condition after 24 months follow-up, without tumor recurrence and metastasis.