Clinical analysis of immunotherapy rechallenge in advanced gastric cancer / 中华肿瘤杂志

Objective: To evaluate the efficacy and influencing factors of programmed death protein 1 (PD-1) monoclonal antibody rechallenge therapy in advanced gastric cancer (GC). Methods: The clinical data of patients with advanced GC who were treated with anti-PD-1 rechallenge in Henan Cancer Hospital from January 2020 to December 2021 were collected retrospectively. The progression-free survival (PFS) was defined as the time from the first or second used of anti-PD-1 treatment to the date of disease progression or the last follow-up, named PFS(1) and PFS(2), respectively. Kaplan-Meier method and Log rank test were used for survival analysis, Cox proportional hazard model was used to analyze the influencing factors. Results: A total of 60 patients with anti-PD-1 rechallenge therapy were collected, the median follow-up time was 12.2 months. The median progression-free survival (PFS(2)) of anti-PD-1 rechallenge therapy was 2.9 months, the objective response rate (ORR) was 16.7%, and the disease control rate (DCR) was 55.0%. The median PFS(2) of the first and second anti-PD-1 identical and different rechallenge treatment was 3.5 months and 1.9 months (P=0.007) respectively. The median PFS(2) of positive PD-L1 expression in rechallenge therapy was 3.4 months, ORR was 22.7%, and DCR was 63.6%; the median PFS(2) was 4.5 months, ORR was 27.3%, and DCR was 54.5% in patients with median PFS(1)≥6 months. Multivariate analysis showed that peritoneal metastasis was independently associated with anti-PD-1 rechallenge therapy with PFS(2) (HR=2.327, 95% CI, 1.066-5.082, P=0.034). The incidence of adverse reactions in grade 1-2 and grade 3-4 of anti-PD-1 rechallenge therapy was 83.3%, and 35.0%, respectively, and the safety was controllable. Conclusion: Rechallenge therapy with anti-PD-1 is a feasible treatment in advanced GC, but the screening of suitable population for rechallenge therapy still needs prospective data analysis and verification.

Numerical Study on the Process of Human Brain Cooling Treated by Hemoperfusion Mild Hypothermia / 中国医疗器械杂志

Mild hypothermia, as a common means of intraoperative nerve protection, has been used in clinical practice. Compared with the traditional methods such as freezing helmet and nasopharyngeal cooling, hypothermic blood perfusion is considered to be a promising treatment for mild hypothermia, but it lacks experimental and theoretical verification of its cooling effect. In this study, the commercial finite element simulation software COMSOL combined the Pennes equation with the cerebrovascular network model to construct a new simplified human brain model, which was further used to simulate the cooling process of cerebral hypothermic blood perfusion. When the hypothermic blood perfusion was 33 ℃, the human brain could enter the mild hypothermic state within 4 minutes. By comparing with helmet cooling, the feasibility and efficiency of the blood perfusion scheme were verified. By comparing with the calculation results based on Pennes equation, the rationality of the model constructed in this study were verified. This model can non-intrusively predict the changes of brain temperature during surgery, and provide a reference for the setting of treatment parameters such as blood temperature, so as to provide personalized realization of safer and more effective mild hypothermia neuro protection.

Research on the harmonious driving mechanism of doctors′ collaboration willingness and behavior in the tiered diagnosis and treatment system / 中华医院管理杂志

Objective:To explore the driving mechanisms of doctors′ collaborative willingness and behavior in the tiered diagnosis and treatment system, in order to provide reference for promoting the construction of the tiered diagnosis and treatment system.Methods:Based on the harmonious management theory, a theoretical framework for the driving mechanisms of doctors′ collaborative behavior in the tiered diagnosis and treatment system was developed. Through random sampling, a questionnaire survey was conducted among doctors from 40 medical institutions in five prefecture-level cities in Zhejiang province between April and May 2022. The t-test, variance analysis, and non-parametric tests were employed to analyze the differences in collaborative willingness and behavior among doctors based on various demographic characteristics. The structural equation model and stratified linear regression were used to assess the impact of collaborative factors (professional environment and work expectations) and harmonious factors (perception of policy support and perception of management mechanism) on doctors′ collaboration willingness and behavior. Results:A total of 1 959 doctors participated in the survey. Doctors′ collaborative behavior scored 2.13±1.12, indicating a slightly below-average level, whereas their willingness to collaborate scored 3.88±0.79, falling between neutral and somewhat willing. Significant differences in collaborative behavior scores were observed based on the medical institution′s ranking, age, years of experience, monthly average income, and professional titles ( P<0.05). Both collaborative and harmonious factors directly influenced the doctors′ willingness to collaborate, with standardized path coefficients of 0.428 and 0.139, respectively. Similarly, these factors directly impacted their collaborative behavior, with standardized path coefficients of 0.104 and 0.366. The perceptions of policy support and management mechanisms demonstrated a significant positive moderating effect on the relationship between doctors′ collaborative willingness and behavior, with effect values of 0.047 and 0.043 respectively ( P<0.05). Conclusions:The collaborative and harmonious elements serve as positive drivers for collaboration among doctors in the tiered diagnosis and treatment system at both the cognitive and behavioral levels. Enhancing and optimizing policy support and management mechanisms can facilitate the transition from intention to actual collaborative actions among doctors from different levels of medical institutions.

Effects of schoolbags use on musculoskeletal health among adolescents / 中国学校卫生

Abstract@#Previous epidemiological studies indicated that weight of schoolbag in most countries is far higher than that recommended guidelines. Heavy schoolbags seriously affect the healthy development of the musculoskeletal system of adolescents, which not only leads to abnormal posture e.g. rounded shoulders, hunchback and head forward, but also is one of the main causes of adolescent musculoskeletal diseases such as cervical spondylosis, low back pain and scoliosis. However, adolescents and their parents do not fully understand the harm of heavy schoolbags, let alone the health knowledge regarding the choice and use of schoolbags. Therefore, the review introduces current evidence regarding the association between schoolbag and adolescent musculoskeletal system diseases, as well as schoolbag selection and use, with the aim to arouse the attention of teenagers and their parents and relevant health education departments.

The value of intravoxel incoherent motion diffusion weighted imaging parameters combined with texture analysis of primary lesion of rectal adenocarcinoma to predict preoperation non-enlarged lymph node metastasis / 中华放射学杂志

Objective:To investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) parameters combined with T 2WI texture analysis of primary lesions of rectal adenocarcinoma in preoperative prediction of lymph node metastasis with short diameter ≤9 mm. Methods:Retrospective analysis was performed on 115 cases of rectal adenocarcinoma confirmed by surgical pathology in Affiliated Provincial Hospital of Anhui Medical University from June 2015 to October 2020. All patients underwent total mesorectal resection and received conventional rectal MRI and IVIM-DWI scan before surgery. According to the pathological results of lymph node, the patients were divided into lymph node metastatic group ( n=44) and non-metastatic group ( n=71). IVIM-DWI parameters of primary rectal adenocarcinoma were measured including apparent diffusion coefficient (ADC), diffusion coefficient (D), pseudo diffusion coefficient (D *) and perfusion fraction (f). The region of interest (ROI) of the whole lesion of rectal adenocarcinoma was delineated on axial T 2WI; then the ROIs were imported into GE Analysis Kit software to extract 3D texture feature. The differences of IVIM-DWI parameters and texture feature parameters were compared between two groups using independent sample t test or Mann-Whitney U test. The optimal texture feature parameters with independent predictive function were screened by multivariate logistic regression. Then the texture feature model and combined model based IVIM-DWI and texture feature parameters were established. The receiver operating characteristic (ROC) curves were used to evaluate the performances of IVIM-DWI, texture feature parameters, texture feature model and combined model in predicting lymph node metastasis in patients with rectal adenocarcinoma. The area under the ROC curve (AUC) were compared with DeLong test. Results:Among all the IVIM-DWI parameters, the D * and f values of primary rectal adenocarcinoma were significantly different between the lymph node metastasis group and the non-lymph node metastasis group ( Z=3.39, P=0.001, Z=-3.06, P=0.002); no statistical significance was found in the ADC and D values between two groups (both P>0.05). A total of 828 texture feature parameters were obtained based on T 2WI of primary lesion of rectal adenocarcinoma, among which 3 optimal texture feature parameters were selected, including firstorder_Skewness, shape_Sphericity and glcm_Idn. The ROC curve results showed that the AUC of D * and f were 0.689 and 0.670, respectively. The AUC of 3 texture feature parameters were 0.651, 0.628, 0.631, respectively. The AUC of texture feature model and the combined model were 0.775 and 0.803. The AUC of combined model was larger than D *, f and the three texture feature parameters (all P<0.05). Conclusion:IVIM-DWI parameters combined with T 2WI texture feature parameters in primary lesion of rectal adenocarcinoma show good diagnostic efficacy in preoperative prediction of lymph node metastasis with short diameter≤9 mm.

Nomogram based on IVIM-DWI and radiomics in predicting recurrence after concurrent chemoradiotherapy for patients with cervical cancer / 中华放射肿瘤学杂志

Objective:To investigate the value of nomogram based on intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and MRI-derived radiomics for predicting recurrence after concurrent chemoradiotherapy (CCRT) in patients with locally advanced cervical cancer (LACC).Methods:Clinical data of 111 patients with ⅠB-ⅣA cervical cancer who underwent CCRT at Anhui Provincial Hospital from December 2014 to December 2019 and were continuously followed up were retrospectively analyzed. Pre-treatment IVIM-DWI parameters (ADC, D, D * and f) and pre- and post-treatment 3D texture parameters (from axial T 2WI) of the primary lesions were measured. Least absolute shrinkage and selection operator (LASSO) algorithm and multivariate logistic regression analysis were used to filter texture features and calculate radiomics score (Rad-score). A Cox regression model was used to analyze independent risk factors for recurrence after CCRT in patients with LACC and construct a nomogram. Results:External beam radiotherapy dose, f value , pre-treatment Rad-score and post-treatment Rad-score ( HR=0.204, 3.253, 2.544, 7.576) were the independent prognostic factors for recurrence after CCRT in cervical cancer patients and jointly formed the nomogram. The area under curve (AUC) of the nomogram for predicting 1-, 3- and 5-year disease-free survival (DFS) was 0.895, 0.888 and 0.916, with internal validation C-indexes of 0.859, 0.903 and 0.867, respectively. The decision curves analysis showed that the nomogram has a higher net clinical benefit compared to other models, and the clinical impact curves further visualized its predictive accuracy. Conclusions:The nomogam based on IVIM-DWI and radiomics has high clinical value in predicting recurrence after CCRT in patients with LACC, providing reference for prognostic assessment and individualized treatment of cervical cancer patients.

Relationship between hepatitis B virus genotyping and primary hepatocellular carcinoma of 182 patients / 公共卫生与预防医学

Objective To analyze the relationship between hepatitis B virus genotyping and primary liver cancer (PHC) in Wuhan, and to provide a theoretical basis for the early prevention and diagnosis of PHC. Methods Patients with chronic hepatitis B (CHB) from Wuhan Sub-heart General Hospital for treatment from February 2020 to February 2021 were selected and divided into PHC group (182 cases) and control group (189 cases) according to whether they were complicated with primary liver cancer. 5ml of fasting elbow venous blood was taken from all subjects at admission. HBV genotyping was determined by real-time fluorescence quantitative PCR. The DNA of CHB virus was determined by fluorescence probe hybridization and PCR amplification, and genotyping and drug-resistant mutation points were detected according to the product sequencing analysis. Spearman linear correlation analysis was used to analyze the correlation between genotyping and mutation rate of PHC patients. Results The proportion of C genotype in PHC group was significantly higher than that in non-PHC group (P0.05). The proportion of HEPATITIS B virus mutation in PHC group (114/182) was significantly higher than that in control group (84/189) (χ2=12.331, P0.05). The proportion of HBV C mutant in PHC group was significantly higher than that in control group (P1=0.349, r2=0.305, P<0.05). Conclusion The HBV genotype of PHC patients is mainly TYPE C, and has a high mutation rate of C genotype. It can be used for diagnosis of PHC by detecting the genotyping of CHB and mutation rate of C genotype in clinic.

The citation analysis of the articles published in Chinese Journal of Otorhinolaryngology Head and Neck Surgery from 2009 to 2019 / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the citation of articles in Chinese Journal of Otorhinolaryngology Head and Neck Surgery, and to explore the strategy for running scientific journals. Methods: Using the Citation Database of Chinese Biomedical Journals, the citations of articles in this journal from 2009 to 2019 were statistically analyzed, and the characteristics of highly cited articles were analyzed. Results: From 2009 to 2019, Chinese Journal of Otorhinolaryngology Head and Neck Surgery published 2 814 papers. Cited papers accounted for 75.69% of all papers, and each paper was cited 7.24 times. The citation rate of published papers was consistent with the variation trend of citation frequency. Non treatises such as guide consensus and original articles for special issues were cited better. There was no obvious correlation between paper funding and citation. Conclusion: Improving the content quality and optimizing the column setting are important measures to enhance the influence of scientific journals.

Clinical effect of free fibular flap without vein of great toe in repairing soft tissue defect of finger pulp / 中华显微外科杂志

Objective:To investigate the clinical effect of free fibular flap of great toe without vein in repairing soft tissue defect of finger pulp.Methods:From June 2020 to January 2021, 8 cases of finger pulp soft tissue defect were repaired with free flap of fibular side of great toe without vein, including 6 males and 2 females, with an average age of 32(18-42) years old. The defect area of finger pulp was 1.0 cm×0.5 cm-1.8 cm×0.8 cm. The proper digital artery and digital nerve of the affected finger were anastomosed. All flaps did not carry reflux veins. The donor site of the toe was directly sutured. Postoperative routine anti infection, anti spasm and anticoagulant treatment was performed. Postoperative outpatient regular follow-up.Results:All flaps survived without vascular crisis, and the donor and recipient sites healed in the first stage. All patients were followed-up for an average of 6.4(4-12) months. At the last follow-up, the TPD was 6-8 mm, the hand function was evaluated according to the Trial Standard of Upper Limb Function Evaluation of Hand Surgery Society of Chinese Medical Association. Seven cases were excellent and 1 case was good.Conclusion:The free fibular flap of the great toe can be used to repair the small wound of finger pulp without carrying the draining vein, the flap can still survive. And it can provide a certain reference for the failure of anatomic separation of the draining vein.

Research progress and trend analysis of medical insurance governance in China based on CNKI database / 中华医院管理杂志

Objective:To analyze the research hot topics, knowledge evolution context, potential frontier trends and future breakthrough directions in the field of medical security governance in China.Methods:Subject term retrieval was used to study the literatures related to medical security governance published by CNKI from January 2009 to December 2021. CiteSpace V software was used to draw the keyword co-occurrence network, time zone map, cluster map, and emergent word graph, and to visually analyze and predict the frontier hotspots and evolution trends in the field of medical security governance.Results:A total of 793 literatures were retrieved. The cooperation network among medical security governance research institutions in China needed to be strengthened; the mainstream of research focused on basic research on medical insurance system design, research on medical security governance paths and methods, and empirical research combined with the era background or policy hotspots.Conclusions:There are some problems in the current rerearch on medical security governance, such as imperfect theoretical construction, research content to be expanded, insufficient communication and cooperation, etc. Future research hotspots tend to be innovation of the goal, structure and path of medical security governance, application of big data in the field of medical security governance, and research on crisis response and challenges of medical security governance under public health emergencies. Future research should strengthen multi-cooperation to jointly tackle key problems, pay attention to the cross-integration of disciplines, develop localized medical security governance innovation systems and mechanisms, and enrich problem-oriented empirical research.

Progress of acute attack of asthma with hypercoagulable state in children / 国际儿科学杂志

Bronchial asthma in children is a common chronic inflammation of the lower airway.It is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsiveness.Acute asthma attack in different degrees is often accompanied by multiple system damage, including respiratory system, circulatory system, blood system and so on.At present, the literature reports about acute attack of asthma accompanied by thrombophilia, thrombosis, pulmonary embolism and other life-threatening complications gradually appear, and show an upward trend.This paper summarizes the literature of acute asthma attack with thrombophilia at home and abroad, and reviews the pathogenesis, monitoring indicators and treatment, so as to diagnose and treat early, prevent serious complications and reduce mortality.

Anti-rheumatoid arthritis potential of diterpenoid fraction derived from Rhododendron molle fruits / 中国天然药物

Rhododendron molle G. Don is first recorded in Shengnong's Herbal Classic, and its fruits, which are termed as Liuzhouzi, are often used to treat rheumatoid arthritis in Chinese folk. During our ongoing investigation to develop a safer and potential new arthritis therapy, a process for the preparation of diterpenoid fraction from Rhododendron mollefruits was established. In order to evaluate the main components and the anti-rheumatoid arthritis effect of the diterpenoid fraction, phytochemical and pharmacological experiments were used. As the result, the main components of diterpenoid fraction were identified as rhodojaponin III (1), rhodojaponin VI (2), 2-O-methylrhodojaponin (3), and 5'-β-D-glucopyranosy-loxyjasmonic acid (4). These four components constitute greater than 95% of diterpenoid fraction using area normalization method of HPLC-ELSD. The results of CIA rat experiment showed that high dose of diterpenoid fraction (0.6 mg·kg

Efficacy and safety of Nocardia rubra cell wall skeleton for the treatment of erosive oral lichen planus / 北京大学学报(医学版)

OBJECTIVE@#To observe the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) for the treatment of erosive oral lichen planus (EOLP).@*METHODS@#Sixty patients with clinically and pathologically diagnosed EOLP were randomly divided into the experimental group and control group according to the random number. Patients in the experimental group were treated with lyophilized powder containing Nr-CWS combined with normal saline. Patients in the control group received topical placebo without Nr-CWS combined with normal saline. Changes in the EOLP lesion area and the patient's pain level were recorded at the timepoints of weeks 1, 2, and 4 after the two different treatments, respectively. The changes of the patient's REU scoring system (reticulation, erythema, ulceration), the visual analogue scale and the oral health impact score (OHIP-14) were compared between the experimental group and control group after treatment, and the safety indicators of the two groups at the initial diagnosis and after 4 weeks' treatment were also observed, respectively.@*RESULTS@#Totally, 62 patients with clinically and pathologically diagnosed EOLP were enrolled, 2 of whom were lost to the follow-up, with 31 in the experimental group, and 29 in the control group. The mean age of the experimental group and control group were (52.9±12.4) years and (54.07±12.40) years, respectively. There was no significant difference in the oral periodontal index between the experimental group and control group. In the experimental group, the erosive area of oral lichen planus was significantly reduced 1, 2, and 4 weeks after the Nr-CWS's treatment (P < 0.05), the reduction rate was 81.75%, the patient's pain index was also decreased (P < 0.05), and in addition, the OHIP-14 was reduced (P < 0.05). The changes of the REU scoring system, the visual analogue scale and the OHIP-14 were significantly different between the experimental group and control group after treatment. There was no significant difference in the safety index between the two groups.@*CONCLUSION@#The priliminary data show that the Nr-CWS is effective and safe to treat EOLP.

Mediating effect of general self-efficacy between stress coping personality and perceived professional benefits among nursing interns / 中国职业医学

OBJECTIVE: To explore the mediating effect of the general self-efficacy(GSE), stress coping personality(SCP) and perceived professional benefits(PPB) among nursing practice students. METHODS: A total of 836 nursing interns from six grade A hospitals in six cities were selected as the research subjects using convenience sampling method. The GSE, SCP and PPB were investigated by the General Self-Efficacy Scale, Scale of Stress Coping Personality for College Students and Questionnaire of Nurses Perceived Professional Benefit. RESULTS: The average scores of GSE, SCP, and PPB were(24.6±5.8),(183.1±28.7) and(139.5±18.0), respectively. The scores of GSE and SCP were positively correlated with that of PPB [correlation coefficients(r) were 0.31 and 0.38 respectively, both P<0.01], and a positive correlation was found between GSE and SCP(r=0.41, P<0.01). The hierarchical regression results showed that the sense of control, tenacity and tolerance of SCP of the interns had a predictive effect on their PPB(all P<0.05); but the effect of SCP on PPB was weakened after inclusion of GSE(P<0.01). The structural equation model analysis results showed that both SCP and GSE of interns had a direct positive predictive effect on PPB(all P<0.01), GSE played a partial mediating role between SCP and PPB, accounting for 20.3% of the total effect. CONCLUSION: The SCP of nursing interns can directly or indirectly affect their PPB, and GSE plays a partial mediating effect between SCP and PPB.

Analysis of INS gene variant in a juvenile with maturity-onset diabetes of the young type 10 / 中华医学遗传学杂志

OBJECTIVE@#To analyze INS gene variant in a patient with maturity-onset diabetes of the young type 10.@*METHODS@#High-throughput sequencing was used to screen for the variants. Suspected variant was verified by Sanger sequencing.@*RESULTS@#Genetic testing indicated that the patient and his mother have both carried a heterozygous c.130G>A (p.Gly44Arg) variant in exon 1 of the INS gene. Prediction of protein structure suggested the variant to be pathogenic.@*CONCLUSION@#The c.130G>A (p.Gly44Arg) variant of the INS gene probably underlies the disease in this patient.

Penehyclidine Hydrochloride Premedication Is Not Associated with Increased Incidence of Post-Operative Cognitive Dysfunction or Delirium:A Systemic Review and Meta-Analysis / 中国医学科学杂志(英文版)

Objective Post-operative cognitive dysfunction (POCD) and post-operative delirium (POD) are two common post-operative cerebral complications. The current meta-analysis was to systematically review the effects of penehyclidine hydrochloride (PHC) on POCD and POD in surgical patients.Methods Electronic databases were searched to identify all randomized controlled trials comparing PHC with atropine/scopolamine/placebo on POCD and POD in surgical patients. Primary outcomes of interest included the incidences of POCD and POD; the secondary outcomes of interest included peri-operative mini-mental state examination (MMSE) scores. Two authors independently extracted peri-operative data, including patients' baseline characteristics, surgical variables, and outcome data. For dichotomous data (POCD and POD occurrence), treatment effects were calculated as odds ratio () and 95% confidential interval (). Each outcome was tested for heterogeneity, and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity. For continuous variables (MMSE scores), treatment effects were calculated as weighted mean difference (WMD) and 95% . Statistical significance was defined as <0.05.Results Our search yielded 33 studies including 4017 patients. Meta-analysis showed that, the incidence of POCD in PHC group was comparable to that in saline group (=0.97; 95% : 0.58-1.64; =0.92), scopolamine group (=0.78; 95% : 0.48-1.27; =0.32) and atropine group (=1.20; 95% : 0.86-1.67; =0.29). The incidence of POD in PHC group was comparable to that in saline group (=1.53; 95% : 0.81-2.90; =0.19) and scopolamine group (=0.53; 95% : 0.06-4.56; =0.56), but higher than that in atropine group (=4.49; 95% : 1.34-15.01; =0.01).Conclusions PHC premedication was not associated with increased incidences of POCD or POD as compared to either scopolamine or placebo.

Predictive value of IVIM-DWI and DCE-MRI quantitative parameters on the early efficacy of concurrent chemoradiotherapy for cervical squamous cell carcinoma / 中华放射肿瘤学杂志

Objective:To evaluate the application value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and dynamic contrast enhancement MRI (DCE-MRI) in the prediction of the early efficacy of concurrent chemoradiotherapy (CCRT) for cervical squamous cell carcinoma.Methods:Fifty patients with cervical squamous cell carcinoma confirmed by pathology were included. Before CCRT, IVIM-DWI and DCE-MRI were scanned, and the values of quantitative parameters including ADC, D, D * and f of IVIM-DWI and K trans, K ep, V e and V p of DCE-MRI before treatment were measured for all patients. MRI reexamination was performed 1 month after the end of CCRT, and all patients were divided into the cure group and the residual group according to the tumor remission. The parameters of IVIM-DWI and DCE-MRI before treatment were statistically compared between two groups. The optimal predictive parameters and predictive thresholds were determined by drawing the receiver operating characteristic (ROC) curve. Results:Twenty-four patients were assigned into the cure group and twenty-six patients in the residual group. The ADC, D and V e values before treatment in the cure group were significantly lower than those in the residual group (all P<0.05), whereas the f and K trans values were significantly higher than those in the residual group (both P<0.05). The other parameters did not significantly differ between two groups (all P>0.05). The area under ROC curve (AUC=0.823) of D value was the largest, followed by K transvalue (AUC=0.754). The combined prediction efficacy of D and K trans (AUC=0.867) was higher than that of either D or K trans alone. The sensitivity was 88.5%, 85.8% and 88.8%, and the specificity was 70.8%, 66.7% and 79.2%, respectively. Conclusions:Quantitative parameters of IVIM-DWI and DCE-MRI before treatment have certain predictive value for the early efficacy of CCRT in cervical squamous cell carcinoma, among which the predictive efficacy of D value is the highest, and the combined application of D and K trans can improve the predictive efficacy.

Analysis on changes of fluoride in rural centralized water supply in Inner Mongolia Autonomous Region from 2014 to 2018 / 中华地方病学杂志

Objective:To understand the situation and distribution of fluoride in rural centralized water supply in Inner Mongolia Autonomous Region (Inner Mongolia for short), and provide a reference for adjustment of prevention and control measures.Methods:From 2014 to 2018, 836, 947, 1 033, 1 068, 1 099 rural centralized water supply monitoring sites were designated in 77 banners (counties, districts) separately in Inner Mongolia, and factory water and tip water samples were collected during plentiful phase and exhausted phase every year, respectively, and fluoride content was tested. Descriptive analysis was done according to time, water period (plentiful phase and exhausted phase), water sample type (factory water and tip water), water treatment method (conventional treatment, sedimentation and filtration, only disinfection and untreated), area distribution [eastern region (Hulunbuir, Xing'an League, Tongliao and Chifeng), central region (Hohhot, Baotou, Ulanqab and Xilinhot) and western region (Ordos, Bayannur and Alashan)], and the results were analyzed visually by ArcMAP 10.2.Results:From 2014 to 2018, 3 251, 3 671, 4 058, 4 087 and 4 395 water samples were collected, the medians fluoride were 0.69, 0.70, 0.69, 0.64 and 0.66 mg/L, and the annual compliance rates of fluoride were 80.31% (2 611/3 251), 81.83% (3 004/3 671), 83.14% (3 374/4 058), 85.91% (3 511/4 087) and 84.57% (3 717/4 395). The difference of compliance rate of fluoride in rural centralized water supply in different years was statistically significant (χ 2=51.748, P < 0.01), and the compliance rate of fluoride showed an increasing trend with the years (χ 2=41.140, P < 0.01). The compliance rates of fluoride in plentiful phase and exhausted phase were 83.36% (8 128/9 750) and 83.29% (8 089/9 712), respectively, and the difference was not significant statistically (χ 2=0.020, P > 0.05). As for water sample type, the compliance rates of fluoride in factory water and tip water were 83.55% (6 583/7 879) and 83.17% (9 628/11 576), and the difference was not significant statistically (χ 2=0.485, P > 0.05). The difference of compliance rate of fluoride in different water treatment methods was statistically significant (χ 2=192.014, P < 0.01). The compliance rates of fluoride in water with conventional treatment and only disinfection were higher [95.51% (404/423) and 94.44% (986/1 044)]; and the untreated water had the lowest compliance rate of fluoride [81.75% (13 073/15 991)]. There was a statistically significant difference in compliance rates of fluoride in the eastern, central and western regions (χ 2=629.256, P < 0.01), with the eastern region had the highest compliance rate of 89.17% (7 337/8 228); the central region had the lowest compliance rate of 74.67% (5 391/7 220). The visualization results showed that the compliance rate of fluoride was obviously low in the central region north of Yin Mountains and west of Greater Higgnan Mountains. Conclusions:From 2014 to 2018, the compliance rates of fluoride in rural centralized water supply increase year by year, and some achievements have been made in fluorine reduction and water improvement project in Inner Mongolia. However, there are still some rural areas with low level of water fluoride compliance rates which mainly distribute in the central region of Inner Mongolia in the north of Yin Mountains and west of Greater Higgnan Mountains. The current focus of prevention and control should be shifted from "general control" to "precise fluorine control". In the future, it is necessary to implement treatment projects in key areas of fluorine pollution from the aspects of policy implementation and technological innovation to ensure the drinking water safety of local rural residents.

Effect of lentiviral vector mediated RNA binding protein quaking-5 on the proliferation and apoptosis of lung adenocarcinoma cell line H1299 / 解剖学报

To investigate the proliferation and apoptosis of lung adenocarcinoma cells line HI299 by the lentiviral vector mediated RNA binding protein quaking-5 ( QKI-5). Methods GV358 ( up-regulation ) and GV248 ( down-regulation) vectors were used to construct the lentiviral QKI-5 up-regulation vector and down-regulation vector, respectively. The vectors were transfected into 293T cells for lentiviral packaging and viral titer were then determined. Gene sequencing was performed to screen the sequence of vectors. Then Real-time PCR was used to evaluate the expression of QKI-5 mRNA and the proliferation of H1299 cells was examined by colony forming assay after transfection. The apoptosis of HI299 cells was determined by the detection of the expression membrane protein V (annexin V ) and propyl iodide ingot (PI) by flow cytometry. Pro-apoptotic protein Caspae-3 and Caspase-8 were evaluated by Western blotting. Results QKI-5 up-regulation and down-regulation lentiviral vectors were constructed successfully. Compared with the controls, the expression of QKI-5 mRNA of HI299 cells was up-regulated, the cell colony formation was decreased, and the early apoptosis of HI299 cells was increased with the over-expression of Caspase-8 after transfected with up-regulated vector, whereas transfecting with QKI-5 down-regulated vector had opposite effect. Conclusion Lenviral vector mediated QKI-5 could inhibit proliferation and promote apoptosis of lung adenocarcinoma cells through Caspase-8.

Sex Characteristics and Distribution of External Ear in Uygur Population of Xinjiang / 法医学杂志

Objective To analyze the characteristics of the bilateral external ears of Uygur adults by directly observing the morphological characteristics of the external ears of Uygur adults and classifying each feature. The frequency distribution of the characteristics was calculated to provide reference for forensic identification. Methods The 210 cases （75 males and 135 females） of bilateral external ear photos of Uygur adults in Xinjiang that met the inclusion criteria were collected. The frequencies of the features of the external ear were recorded and distinguished between the two sexes and the different sides. The data were statistically analyzed by SPSS 21.0 statistical software. Results The shapes of the external ears of males and females were commonly oblique or rectangular （34.67% of the left external ear of males and 41.33% of the right were oblique; 30.37% of the left and right external ear of females were rectangular）, while triangular ears were the rare variants and the least common. Sex and bilateral differences were observed as regards the form of the helix in the subjects. Normally rolled helix was the most common （58.67% males and 61.48% females for the left ear; 60.00% males and 72.59% females for the right ear）. Wide covering scapha helix was the most rare for the male left ear and flat helix was the most rare for the female right ear. Square and free earlobes were the most common （49.33% males and 62.96% females for the left ear; 40.00% males and 54.81% females for the right ear）, whereas triangular earlobes were rarely seen. Single knob tragus （40.00% males and 37.78% females for the left ear; 37.33% males and 33.33% females for the right ear） and projection type of Darwin's tubercle （50.67% males and 40.00% females for the left ear; 48.00% males and 39.26% females for the right ear） were found to be common. Conclusion The characteristics of the bilateral external ears of male and female Uygur adults have differences, which can be used for forensic identification.