Efficacy and safety of deep hyperthermia combined with sintilimab and nab-PC regimen in the treatment of advanced squamous non-small cell lung cancer with driver gene negative and PD-L1 expression positive / 肿瘤研究与临床

Objective:To investigate the clinical efficacy and safety of deep hyperthermia combined with sintilimab and nab-PC (albumin-bound paclitaxel + carboplatin) regimen in the treatment of advanced squamous non-small cell lung cancer (NSCLC) with driver gene negative and programmed death-1 receptor ligand 1 (PD-L1) expression positive.Methods:A prospective case-control study was performed. A total of 84 advanced squamous NSCLC patients with driver gene negative and PD-L1 expression positive in Hebei Seventh People's Hospital from January 2020 to December 2022 were collected, and all patients were divided into the observation group and the control group according to the random number table method, with 42 cases in each group. The control group was given the treatment of sintilimab combined with nab-PC regimen, and the observation group was given deep hyperthermia on the basis of the control group. After 4 consecutive cycles of treatment, the short-term efficacy of the two groups was compared. The levels of serum tumor markers [carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA), cytokeratin fragment 19 (CYFR21-1)], and the positive expression rates of immunohistochemistry markers [p40, p63, and cytokeratin 5/6 (CK5/6)] before and after treatment were compared between two groups. Functional Assessment of Cancer Therapy-Lung cancer module (FACT-L) scores, the adverse reactions and the long-term survival of the two groups were compared.Results:There were 26 males and 16 females in the observation group, and the age was (59±11) years; there were 22 males and 15 females in the control group, and the age was (58±11) years. The objective remission rate and the disease control rate were 71.43% (30/42), 90.48% (38/42), respectively in the observation group, and 50.00% (21/42), 80.95% (34/42), respectively in the control group; the objective remission rate in the observation group was higher than that in the control group, and the difference was statistically significant ( χ2 = 4.04, P = 0.044); and there was no statistically significant difference in the disease control rate of both groups ( χ2 = 1.56, P = 0.212). The levels of serum CEA, SCCA and CYFRA21-1, and the positive expression rates of p40, p63, and CK5/6 in the two groups after treatment were lower than those before treatment (all P < 0.05); and the scores of physiological status, functional status, additional concern in FACT-L scores and the total score of the scale after treatment were higher than those before treatment (all P < 0.05). There were no statistically significant differences in the incidence of adverse reactions including thrombocytopenia, neutropenia, leukopenia, anemia, fever of the two groups (all P > 0.05). The median progression-free survival (PFS) time was 6.5 months (95% CI: 3.82-12.75), 5.1 months (95% CI: 3.14-12.26),respectively in the observation group and the control group, and the difference in the median PFS time was statistically significantly of both groups ( χ2 = 4.21, P = 0.040). The median overall survival (OS) time was 12.9 months (95% CI: 6.25-15.46), 9.7 months (95% CI: 4.74-13.02), respectively in the observation group and the control group, and the difference in the median OS time was statistically significantly of both groups ( χ2 = 4.43, P = 0.035). Conclusions:Deep hyperthermia combined with sintilimab and nab-PC regimen in the treatment of advanced squamous NSCLC with driver gene negative and PD-L1 expression positive can effectively reduce the serum tumor markers levels and positive expression rate of immunohistochemical markers, improve the quality of life of patients, and increase the short-term and long-term efficacy.

Morphological analysis of bone marrow metastases from neuroblastoma and rhabdomyosarcoma in children / 中华检验医学杂志

Objective:To retrospectively analyze the bone marrow smears of neuroblastoma and rhabdomyosarcoma in children and summarize the morphological characteristics of the two types of tumors invading the bone marrow to provide reference for the identification and differential diagnosis.Method:A total of 908 bone marrow specimens were collected from the outpatient and inpatient children who were diagnosed as Neuroblastoma and Rhabdomyosarcoma by pathological tissue or lymph node biopsy in Sun Yat-sen University Cancer Center from January 2013 to July 2020. Of which, 231 cases of tumor bone marrow metastasis were detected. Bone marrow smears were observed and analyzed, classified and summarized according to the morphological characteristics of tumor cells.Result:A total of 231 cases of bone marrow metastases were detected, including two types of tumors, 217 cases Neuroblastoma, with an invasion rate of 34.23%; 14 cases Rhabdomyosarcoma, with an invasion rate of 5.11%. The tumor cells of neuroblastoma were arranged in a pseudo-chrysanthemum or wall-like arrangement and most of them were surrounded by nerve fibers. According to cell size, they could be divided into large cell type and small cell type. Rhabdomyosarcoma cells were mainly medium in size, with vacuoles in the nucleus, and double, triple and multinucleated cells can be seen. The cytoplasm was gauze-like, with bead-like vacuoles at the edges. According to the morphological characteristics of neuroblastoma and rhabdomyosarcoma, they can be differentiated from acute leukemia.Conclusion:Among two malignant solid tumors in children, Neuroblastoma had a higher bone marrow invasion rate, while Rhabdomyosarcoma had a lower bone marrow invasion rate. Rhabdomyosarcoma can be initially divided into embryonal type and acinar type according to whether tumor cells were fused or not.

Multimodality imaging analysis of breast ductal carcinoma in situ within papillomas / 中华放射学杂志

Objective:To investigate the mammography, ultrasound and MRI features of breast ductal carcinoma in situ within papillomas (DCIS-WP) and ductal carcinoma in situ in general (DCIS-IG), and to select the appropriate screening methods for breast cancer.Methods:A retrospective analysis of 134 patients with DCIS-WP and DCIS-IG confirmed by pathology from January 2015 to October 2018 was conducted, including 40 patients with DCIS-WP and 94 patients with DCIS-IG. Mammography, ultrasound and MRI images were analyzed based on BI-RADS criteria, to evaluate the missed diagnosis rate and accuracy rate of three imaging methods, and the consistency of preoperative puncture, intraoperative frozen section and postoperative paraffin section was also observed. Qualitative data were compared using the χ 2 test or Fisher′s exact test. Results:The X-ray missed diagnosis rate of DCIS-WP group and DCIS-IG group was 42.50%（17/40） and 5.32%（5/94）, respectively, while the diagnostic accuracy rate was 22.50%（9/40） and 77.66%（73/94） respectively. The difference between the two groups was statistically significant (χ2=28.268, 35.952, P<0.001). In DCIS-WP group and DCIS-IG group, there were 8 and 2 cases with multiple hypoechoic nodules in the lesions, the difference was statistically significant (χ2=20.819, P<0.001); the missed diagnosis rate was 0 and 24.47%（23/94）, the difference was statistically significant ( P<0.05). On MRI, there were 24 cases and 15 cases of DCIS-WP group and DCIS-IG group with the signs of catheter dilation, 21 cases and 16 cases with multiple papillomas background, 15 cases and 12 cases with sparse internal ring manifestations, 19 cases and 13 cases with different sizes, respectively. The difference between the two groups was statistically significant (χ2=26.378, 17.671, 8.524, 14.530, P<0.05). In DCIS-WP group and DCIS-IG group, 12 cases and 82 cases had the same diagnosis of preoperative puncture, intraoperative frozen pathology and postoperative paraffin pathology respectively, and the difference between the two groups was statistically significant (χ2=44.165, P<0.001). Conclusions:The features of DCIS-WP are different from those of DCIS-IG on mammography and ultrasound. DCIS-WP is likely to be missed on mammography as there is less calcification, while it is easier to be detected by ultrasound. MRI has good diagnostic efficacy for both types of DCIS and is helpful in differentiating them.

Effect of liraglutide combined with clomiphene on serum sex hormone levels and natural conception rate in obese women with polycystic ovary syndrome / 中国基层医药

Objective@#To explore the effect of liraglutide combined with clomiphene on serum hormone levels and natural conception rate in obese patients with polycystic ovary syndrome.@*Methods@#A total of 89 infertile patients with obese polycystic ovary syndrome who were treated in the First People's Hospital of Jinzhong from April 2015 to March 2016 were selected.They were randomly divided into observation group(n=45) and control group (n=44) by simple randomization method.The control group was treated with clomiphene citrate, and the observation group was given liraglutide combined with clomiphene.The fasting blood glucose(FPG), glycosylated hemoglobin(HbAc1), BMI, follicle stimulating hormone(FSH), luteinizing hormone(LH), testosterone(T), total cholesterol(TC), triglyceride (TG), high-density lipoprotein(HDL-C), and low-density lipoprotein(LDL-C) before and after treatment were compared.The menstrual cycle rate, normal ovulation, normal conception, early embryo death, and incidence rate of adverse reaction were recorded after treatment.@*Results@#After treatment, the FPG, HbAc1 and BMI in the observation group were significantly lower than those in the control group(t1=4.144, t2=5.862, t3=5.403, all P<0.05). After treatment, the levels of FSH, LH and T in the observation group were lower than those in the control group(t1=5.972, t2=5.359, t3=6.603, all P<0.05). The levels of TC, TG and LDL-C in the observation group were significantly lower than those in the control group(t1=10.697, t2=5.344, t3=6.986, all P<0.05). The HDL-C of the observation group was higher than that of the control group(t=4.340, P<0.05). After treatment, the menstrual cycle rate, normal ovulation rate, natural conception rate of the observation group were 91.11%, 84.44%, 80.00%, respectively, which were higher than those of the control group (72.72%, 61.36%, 54.54%) (χ12=5.099, χ22=6.017, χ32=6.562, all P<0.05). The early embryo mortality rate of the observation group was 6.67%, which was lower than 27.27% of the control group (χ2=6.741, P<0.05). The total incidence of adverse reactions in the observation group was 8.89%, which was lower than 29.55% in the control group (χ2=6.143, P<0.05).@*Conclusion@#Liraglutide combined with clomiphene in the treatment of obese polycystic ovary syndrome infertility patients can effectively reduce the body weight, regulate blood lipids, glucose metabolism, sex hormone levels, improve the natural conception rate of patients, reduce the incidence of adverse reactions.Its effect is significant.

Effect of liraglutide combined with clomiphene on serum sex hormone levels and natural conception rate in obese women with polycystic ovary syndrome / 中国基层医药

Objective To explore the effect of liraglutide combined with clomiphene on serum hormone levels and natural conception rate in obese patients with polycystic ovary syndrome .Methods A total of 89 infertile patients with obese polycystic ovary syndrome who were treated in the First People's Hospital of Jinzhong from April 2015 to March 2016 were selected.They were randomly divided into observation group (n=45) and control group (n=44) by simple randomization method .The control group was treated with clomiphene citrate , and the observation group was given liraglutide combined with clomiphene .The fasting blood glucose ( FPG ) , glycosylated hemoglobin (HbAc1),BMI,follicle stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),total cholesterol (TC),triglyceride (TG),high-density lipoprotein(HDL-C),and low-density lipoprotein(LDL-C) before and after treatment were compared .The menstrual cycle rate ,normal ovulation ,normal conception ,early embryo death ,and incidence rate of adverse reaction were recorded after treatment .Results After treatment,the FPG,HbAc1 and BMI in the observation group were significantly lower than those in the control group ( t1 =4.144,t2 =5.862,t3 =5.403,all P<0.05).After treatment,the levels of FSH,LH and T in the observation group were lower than those in the control group(t1 =5.972,t2 =5.359,t3 =6.603,all P<0.05).The levels of TC,TG and LDL-C in the observation group were significantly lower than those in the control group (t1 =10.697,t2 =5.344,t3 =6.986,all P<0.05).The HDL-C of the observation group was higher than that of the control group (t=4.340,P<0.05).After treatment,the menstrual cycle rate,normal ovulation rate ,natural conception rate of the observation group were 91.11％,84.44％,80.00％, respectively,which were higher than those of the control group (72.72％,61.36％,54.54％) (χ21 =5.099,χ22 =6.017,χ23 =6.562,all P<0.05).The early embryo mortality rate of the observation group was 6.67％,which was lower than 27.27％ of the control group (χ2 =6.741,P<0.05).The total incidence of adverse reactions in the observation group was 8.89％,which was lower than 29.55％ in the control group (χ2 =6.143,P <0.05). Conclusion Liraglutide combined with clomiphene in the treatment of obese polycystic ovary syndrome infertility patients can effectively reduce the body weight ,regulate blood lipids ,glucose metabolism ,sex hormone levels ,improve the natural conception rate of patients ,reduce the incidence of adverse reactions .Its effect is significant .

Imaging features of primary adenoid cystic carcinoma of the breast / 中国肿瘤临床

Objective: To investigate the imaging features of primary adenoid cystic carcinoma (ACC) of the breast. Methods: In total, 31 patients were confirmed to have primary ACC in the breast based on histopathological findings from January 2012 to September 2018 in Tianjin Medical University Cancer Institute and Hospital. Mammography and ultrasonography findings of these patients were retrospectively analyzed according to the breast imaging-reporting and data system (BI-RADS) recommended by the American College of Radiology (ACR) and compared with pathological findings. Results: Mammography findings in 31 cases of ACC of the breast were as follows: 25 cases with masses, including 16 high-density masses (14 were categorized as BI-RADS 4C or 5, one as 4A, and one as 4B); 7 equal-density masses (5 were categorized as BI-RADS 4B, one as 4A,and one as 3); and 2 mixed-density masses (one was categorized as BI-RADS 4A and one as 2). The other 6 patients presented with focal asymmetric density. No calcification was found in all cases. Ultrasonography findings included hypoechoic mass, mixed-echo mass, and non-mass-like hypoechoic or heterogeneous echoic areas. A total of 22 patients presented with hypoechoic masses; of these, 14 showed typical ultrasonographic findings of breast cancer and their tumors were categorized as BI-RADS 4C or 5. Three patients presented with mixed-echo masses, of which two showed a mixed-echo mass containing hyper-echoic areas and one showed a complex cystic and solid echo mass; all tumors were categorized as BI-RADS 4B. The remaining 6 patients presented with non-mass-like hypoechoic or heterogeneous echoic areas; all were without a tendency to distribute along the direction of the breast ducts. Conclusions: The mammographic and ultrasonographic appearances of primary ACC of the breast are similar to those of general carcinoma, with no specificity. Some specific findings, such as irregular high-density masses containing low-or fatty-density areas with indistinct margins on mammography and mixed-echo masses containing hyper-echo or non-mass-like heterogeneous echoic areas not distributed along the breast duct on ultrasonography, have certain significance. The final diagnosis depends on histopathology.

Exploration and Practice of Drug Abuse Monitoring in Medical Institutions / 中国药房

OBJECTIVE： To explore the method for the development and implementation of drug abuse monitoring in medical institutions， and to provide reference for drug abuse monitoring in medical institutions. METHODS： Our hospital （the affiliated hospital of Binzhou medical college） had established the corresponding drug abuse monitoring mode from the two aspects of real-time monitoring and retrospective analysis， supplemented by relevant management measures， defined the content of drug abuse monitoring in medical institutions， and finally evaluated the implementation effect through the effective reporting quantity of drug abuse information， etc. RESULTS & CONCLUSIONS： The main contents of drug abuse monitoring in our hospital included the establishment of drug abuse monitoring management group， the improvement of drug abuse monitoring system and the sorting out of drug monitoring catalogue； the real-time drug abuse monitoring mode was established through timely reporting drug abuse information by medical， nursing and pharmaceutical personnel in daily diagnosis and treatment activities； at the same time， the retrospective analysis model of drug abuse was established by analyzing the relevant drug use data regularly through the hospital information system， paying attention to the key groups of key departments， and mining drug abuse information； a series of auxiliary management measures were taken， such as strengthening training and publicity， and establishing reward and punishment mechanism. Since the monitoring work was started in 2016， the effective number of drug abuse information reported in 2016-2018 was 38， 126 and 237 respectively， and through the monitoring， it was found that the elderly women over 60 years old （69.83％） were abusing in iatrogenic sedative hypnotic drugs. The development of drug abuse monitoring in hospital can collect drug abuse status， behavior characteristics and relevant information timely and effectively， analyze local drug abuse trends， find drug abuse risks， and provide basis for drug control of narcotics and psychotropic substances supervision.

Development history of tumor radiotherapy in Shanxi province / 肿瘤研究与临床

Tumor radiotherapy is established on the basis of clinical oncology, radio-physics and radiobiology, and has become one of the three major therapeutic methods for malignant tumors. With the pace of socialist construction in China, the subject of radiotherapy in Shanxi province has developed from scratch and from small to large for more than 60 years. Remarkable achievements have been made in the establishment of departments, the updating of technical equipment, the increase of employees and clinical scientific research. This article reviews and summarizes the development history of tumor radiotherapy in Shanxi province.

Comparison of dosimetry between forward intensity-modulated radiotherapy using field-in-field and inverse intensity-modulated radiotherapy for left-sided breast cancer after breast-conserving surgery / 肿瘤研究与临床

Objective@#To compare the dosimetric differences in forward intensity-modulated radiotherapy using field-in-field (FIF-F-IMRT) and inverse intensity-modulated radiotherapy (I-IMRT) for the left-sided breast cancer.@*Methods@#A total of 18 patients with left-sided breast cancer undergoing breast-conserving surgery in Shanxi Provincial People's Hospital from January to July 2015 were enrolled. For each patient, two treatment plans were designed. The plans were compared by means of target dose distribution and dose for organ at risk.@*Results@#The two methods met the requirements of the prescribed doses. There were no differences for maximal dose (Dmax), mean dose (Dmean), and 100%, 105%, 110% prescription dose percent volume (V100, V105, V110) of the target (all P > 0.05). The percentage volume of heart receiving 5 Gy (V5), 20 Gy (V20), 30 Gy (V30), Dmean of heart of FIF-F-IMRT [(11±4)%, (7±4)%, (8±3)%, (15±3) Gy] were lower than those of I-IMRT [(42±8)%, (14±10)%, (14±4)%, (18±7) Gy] (t values were 29.457, 5.542, 5.064, 4.165, all P = 0.000). V5 of left-sided lung of FIF-F-IMRT [(26±6)%] was lower than that of I-IMRT [(47±12)%] (t = 6.708, P = 0.000), but there was no significant difference between the two groups in V20, V30, V40, Dmean of left-sided lung (all P≥0.05). V5 of right-sided lung and right-sided breast, Dmean of right-sided lung of FIF-F-IMRT [(7±4)%, (26±5)%, (60±19) Gy] were lower than those of I-IMRT [(31±9)%, (48±11)%, (489±67) Gy] (t values were 12.304, 6.708, 42.489, all P = 0.000). The number of the monitor units and spending time of FIF-F-IMRT were lower than those of I-IMRT (t values were 12.214 and 29.899, both P = 0.000).@*Conclusion@#FIF-F-IMRT has a good dose distribution in the target volume, and could reduce the dose for organ at risk, especially reduce the unnecessary low dose irradiation, and consume less planning time and equipment consumption.

Clinical characteristics of cognitive function in elderly acute stroke patients with chronic heart failure / 中华老年心脑血管病杂志

Objective To study the clinical characteristics of cognitive function in elderly acute stroke (AS) patients with CHF.Methods Two hundred and seventeen elderly AS patients with CHF were devided into HFrEF group (n=77),HFmrEF (n=46) and HFpEF group (n=94) according to their LVEF.Their clinical data (including baseline demographic data,history of disease,NIHSS score,MMSE score,MoCA score,responsible lesions) were recorded and analyzed.Results The SBP and total MoCA score were significantly lower while the incidence of persistant AF,DM and serum HbA1C level were significantly higher in HFrEF group than in HFmrEF group and HFpEF group (P＜0.05,P＜0.01).The incidence of left ventricular hypertrothy was higher in HFpEF group than in HFmrEF group and HFpEF group (P＜0.01).The total incidence of cognitive impairment was 54.8％ in 217 AS patients with CHF.Logistic regression analysis showed that persistant AF,SBP and DM were the risk factors for cognitive impairment (OR=2.757,P=0.017;OR=0.971,P=0.001;OR=2.293,P=0.031).Conclusion The incidence of cognitive impairment is rather high in elderly AS patients with CHF.Persistant AF,DM and SBP are the risk factors for cognitive impairment.Attention should thus be paid to the assessment of cognitive impairment in elderly AS patients with CHF.

Effect of TLR1 ,TLR2,TLR6 in PBMC from patients with ovarian cancer on tumor microenvironment / 国际检验医学杂志

Objective To explore the pathogenesis of ovarian cancer by investigating the function of Toll-like receptor 1 (TLR1),TLR2 and TLR6 in peripheral blood mononuclear cell(PBMC) from patients with ovarian cancer.Methods PBMC,SK OV 3 co culture system and anti-TLR1,anti-TLR2,anti-TLR6 mAb blocking experiment were used to explore the relationship between TLR1,TLR2 or TLR6 signaling and inflammation in ovarian cancer.Quantitative real time PCR was used to measure interleukin(IL)-1β,IL-6,IL-8,and tumor necrosises factor(TNF)-α in the PBMC.MyD88,TRAF6,TANK,NF-κB and P-NFκB were observed by Western blotting.Results In the PBMC and SK-OV-3 coculture system,we found the activation of TLR signaling pathways,including significantly increased MyD88,TRAF6,TANK and P-NF-κB levels following cocultured with SK-OV-3 in PBMC from ovarian cancer patients.PBMC derived from ovarian cancer patients led to a increase in IL-1β,IL-6 and IL-8 mRNA levels after 24 hours of co-incubation with SK-OV-3 (Fold=1.74,Fold=1.92,Fold=1.65,P＜0.05),though there was no difference of TNF-a mRNA expression.In contrast to the ovarian cancer patients,coculture of PBMC derived from benign diseases controls and healthy normal controls decreased IL-1β at the mRNA level (Fold=0.71,P＜0.05;Fold=0.72,P＜0.05),furthermore the expression of MyD88,TRAF6,TANK,P-NF-κB,and NF-κB showed no changes.PBMC which treated with anti-TLR1,anti-TLR2 or-TLR6 mAb could inhibite inflammatory IL-1β (Fold=0.16,Fold=0.31,Fold=0.29,P＜0.05) and IL-6 (Fold=0.14,Fold=0.20,Fold=0.28,P＜0.05).Conclusion TLR1/TLR2/TLR6 in PBMC of ovarian cancer patients participate in the recognition of the factors.

Effect of the health education of maternal perinatal period by WeChat platform / 中国实用护理杂志

Objective To explore the effect of the health education of maternal perinatal period by WeChat platform. Methods A total of 200 pregnant women were given prenatal examination and delivery in from January 1, 2015 to December 31, 2016. They were divided randomly into two groups according to the attendance card number,each with 100 cases.On the basis of the consent of the pregnant women, the observation group took part in the traditional health education lecture and obtained the continuous maternal and infant health knowledge reeducation by WeChat platform.The control group was not concerned with WeChat platform and only participated in the maternal school curriculum. The three periods of questionnaire survey were analyzed to understand the cognitive degree of maternal health, delivery mode selection and neonatal care of two groups. Results The scores of admission and discharge in the observation group were(77.33 ± 9.64)and(85.26 ± 6.55)points respectively,higher than those in the control group(58.65 ± 7.48)and(64.39 ± 4.48)points,the difference was statistically significant(t=15.097,25.949,P<0.01).The satisfaction was 97.96%(96/98)in the observation group,and 93.75%(90/96) in the control group, the difference was significant (χ2=87.58, P<0.01). Conclusions Health education by WeChat platform play a positive role on the health care knowledge of perinatal period, rational choice of delivery mode and neonatal care ability. The natural childbirth, maternal and family participation and satisfaction are promoted too.

Chances in prevalence of overweight and obesity in a community in Chongqing from 2003-2013 / 重庆医学

Objective To investigate and compare the prevalence of overweight,obesity and central obesity in 2003 and 2013 in a community in Chongqing,and to analyse their prevalence trends.Methods Surveys were conducted in 2003 and 2013 in the community population,and the investigation included questionnaires,anthropometric measurements,blood glucose and lipid determination.Results The number of participants in 2003 and 2013 were 3 073 and 5 938,respectively.The age standardized prevalence of overweight increased from 44.3％ in 2003 to 45.5％ in 2013 in males and declined from 28.3％ to 26.6％ in females,but there was no statistically significant difference(P=0.407,0.260).The age standardized prevalence of obesity was steady in males (10.0％ vs.10.3％,P＞0.05),but declined significantly in females (8.3％ vs.6.3％,P＜0.05).For central obesity,the age standardized prevalence in 2003 and 2013 was 50.9％,53.9％ in males and 39.6％,35.7％ in females,which increased significantly among males and decreased significantly among females (P=0.042,0.017).Conclusion The prevalence of overweight,general obesity and central obesity is relatively high in the community,and males have a more significant increase in the prevalence of central obesity.

Chances in prevalence of overweight and obesity in a community in Chongqing from 2003-2013 / 重庆医学

Objective To investigate and compare the prevalence of overweight,obesity and central obesity in 2003 and 2013 in a community in Chongqing,and to analyse their prevalence trends.Methods Surveys were conducted in 2003 and 2013 in the community population,and the investigation included questionnaires,anthropometric measurements,blood glucose and lipid determination.Results The number of participants in 2003 and 2013 were 3 073 and 5 938,respectively.The age standardized prevalence of overweight increased from 44.3％ in 2003 to 45.5％ in 2013 in males and declined from 28.3％ to 26.6％ in females,but there was no statistically significant difference(P=0.407,0.260).The age standardized prevalence of obesity was steady in males (10.0％ vs.10.3％,P＞0.05),but declined significantly in females (8.3％ vs.6.3％,P＜0.05).For central obesity,the age standardized prevalence in 2003 and 2013 was 50.9％,53.9％ in males and 39.6％,35.7％ in females,which increased significantly among males and decreased significantly among females (P=0.042,0.017).Conclusion The prevalence of overweight,general obesity and central obesity is relatively high in the community,and males have a more significant increase in the prevalence of central obesity.

Traumatic splenic rupture, conservative vs surgical therapy / 中华普通外科杂志

Objective To evaluate management stratagy for patients with traumatic splenic rupture.Methods The clinical data of 124 patients with traumatic splenic rupture admitted to the 422 Hospital of PLA from April 2008 to June 2016 were retrospectively analyzed.38 patients were treated conservatively,while 86 patients underwent surgery.To investigate impact factors of management strategy in patients with traumatic splenic rupture,clinical characteristics and CT features between the two groups were compared.Results Univariate analysis results showed that injury causes,blood pressure,at admission,pulse,CT grade and abdominocentesis were closely related with therapeutic scheme.And multivariate Logistic regression analysis results showed that pulse (OR =4.264,95％ CI 1.206-15.073),CT grade (OR =2.086,95％ CI 1.019-4.271) and abdominocentesis (OR =3.428,95％ CI 1.024-11.479) were the significant determining factors of therapeutic scheme in patients with traumatic splenic rupture.Surgical intervention was carried out in 86 patients accounting for 69.4％ of all patients.The rate of surgical intervention was 58.1％ in the patients with CT grade of 1 and 2,that was 94.7％ in patients with CT grade of 3 and 4.Conclusions Operative management is needed for most traumatic splenic rupture,patients those with hemodynamic stability and CT grade of 1 or 2 may be qualified for watchful non-operative management.

Diagnostic value of coagulation function index in children with ulcerative colitis / 中华实用儿科临床杂志

Objective To explore the diagnostic value of prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-Dimer(DD),antithrombin Ⅲ(ATⅢ),platelet(PLT)in activity and severity assessment of ulcerative colitis(UC),and to analyze whether they could evaluate the degree of activity UC in children.Methods The data of UC patients in the Department of Gastroenterology,Children's Hospital of Nanjing Medical University from January 2012 to September 2016 were analyzed,25 cases of remission and 36 cases of active UC patients were selected as the study subjects.Thirty healthy children were selected as healthy control group,combined with the coagulation function indicators for analysis.Results Receiver operating characteristic area under the curve(AUC)of PT,APTT,FIB,DD,ATⅢ and PLT in UC patients was 0.659,0.840,0.744,0.776,0.599 and 0.792,the activity of UC patients was 0.849,0.889,0.836,0.912,0.964 and 0.966,respectively.The results of PT,APTT,FIB,DD and PLT in children with active UC were significantly higher than those in the healthy control group,and ATⅢ was significantly lower than that in the healthy control group.Compared with the healthy controls,the levels in remission UC patients were not significantly different(P>0.05).The 3 subgroups of activity UC had no significant differences among PT and APTT(F=0.652,1.755,all P>0.05),However,there were significant differences among FIB,DD,ATⅢ and PLT(F=66.495,32.817,88.284,22.892,all P<0.05).FIB,DD and PLT were moderately positively correlated with severity of activity UC patients(r=0.857,0.648,0.654,all P<0.05),and ATⅢ had moderately negative correlation(r=-0.789,P<0.05).Progressive regression analysis showed that the severity of UC was associated with FIB,DD and ATⅢ(R2=0.830,F=39.962,P<0.05).Conclusion FIB,DD and ATⅢ can be used as index for the activity and evaluation of UC.

Current situation and prospect of fertility preservation in male cancer patients / 中国医师杂志

With the rapid development of tumor subjects and the advance of medical technology,tumor mortality is declining in spite of the increase in tumor incidence.The male survivors pay more and more attention to their prognosis to improve the quality of their life.In the meantime,whether they could produce their own offspring become the main concern of tumor patients with good prognosis.However,until now,male tumor patients,their relatives,different social sectors and even some of our health workers,havent noticed the importance of fertility preservation and long-term fertility desires of male patients with tumor which will lead to declined or even irreversible sterility induced by the lack of fertility preservation before anti-tumor therapy.It's an important way to do fertility counseling,learn the risk of their treatment plans and choose the appropriate technique of fertility preservation which will improve prognosis quality of life of male tumor patients.This article will review the effects of tumor and the treatment on male fertility,their subjective needs and concerns,main methods for fertility preservation and the domestic and foreign research present situation.

Effect of Roux-en-Y gastric bypass surgery on renal gluconeogenesis in obese rats / 基础医学与临床

Objective To investigate the effect of Roux-en-Y gastric bypass surgery on renal gluconeogenesis, and to explore the mechanism of improving glucose control and insulin sensitivity in obese rats.Methods Rats were randomly divided into the obese group (n=30) consumed high-fat diet (HFD) and control group (NC group, n=8).Top 24 of animals fed HFD by change in body mass were subdivided into three groups: obese control group (OB group, n=8), obese under RYGB group (RYGB group, n=8) or sham-operation (sham group, n=8).Intraperitoneal glucose tolerance tests (IPGTT) were performed meanwhile the AUC of blood glucose concentration-time after surgery.Fasting glucose, insulin and lipid were measured respectively and HOMA-IR were calculated.The mRNA level and protein level of the key enzymes (G6P and PEPCK) of renal gluconeogenesis were examined with RT-PCR and Western blot respectively.Results Compared with OB group and Sham group, the body mass, lipid, blood glucose, insulin, HOMA-IR and AUG were significantly decreased (P<0.05), the expression of G6P and PEPCK mRNA and protein were significantly reduced(P<0.05) in RYGBgroup.Conclusions Roux-en-Y gastric bypass surgery can improve glucose control and insulin resistance, which may be related to the decreased level of mRNA, protein of G6P and PEPCK, reduced gluconeogenesis and glucose output in renal cortex.

Study on three years dynamic change of professional attitude of nursing undergraduates in traditional Chinese medicine universities and the influencing factors / 中国实用护理杂志

Objective To understand the dynamic change of professional attitude of nursing undergraduates in traditional Chinese medicine universities and the influencing factors from first-year to third-year. Methods From December 2012 to July 2015,“Scale for nurse′s professional attitude”was used to evaluate the professional attitude of full-time nursing undergraduates in two traditional Chinese medicine universities in China in every 18th teaching week of a semester (6 times). Personal information sheet, Eysenck Personality Questionnaire (EPQ) and Social Support Rating Scale (SSRS) were used to screen the influencing factor of professional attitude of nursing undergraduates. Results Mean scores of“Scale for nurse′s professional attitude”in 289 nursing undergraduates was higher than 4.5 and appeared an increasing trend. There were significant differences in professional attitude between first-year and third-year nursing undergraduates. The influencing factors of nursing undergraduates′professional attitude were different. In first-year, the factors were EPQ-N, birthplace, EPQ-P, household registration, parent′s marital status. In second-year, they were times of social practice, mother′s vocation, EPQ-E, EPQ-P, satisfaction on family income. In third-year, they were SSRS scores, EPQ-P, whether first choice being nurse or not. Conclusions Professional attitude of 289 nursing undergraduates is positive and appears an increasing trend. The influencing factors of nursing undergraduates′professional attitude are different and EPQ-P has constant influence on their professional attitude.

Study on the phenotype and function of CD8+Treg cells induced by ovarian cancer cell / 实用医学杂志

Objective To investigate the phenotype and function of CD8+T cells cultured with SK-OV-3. Methods Transwell coculture experiments were conducted in 24-well plates with inner wells to separate CD8+ T cells and SK-OV-3. After 5 days of culture, CD8+ T cells were washed, and 1 × 106 cells were collected for Foxp3, CD25, CD28, CTLA-4 and GITR mRNA analysis and 2 × 106 cells were collected to detect expression of Foxp3, CD25, CD28, CTLA-4 and GITR in CD8+ T cells by flow cytometry. CD8+T cells that cultured alone or with SK-OV-3 were added at ratios of 1∶0 , 1∶1 , 1∶5 , 1∶10 , and 0∶1 to na?ve CD4+ T cells in 96-well plates. All wells were cultured with the presence of irradiated PBMCs and anti-CD3 antibody. After 72 h, [3H]-thymidine was added for 16 h prior to the determination of proliferation by scintillation counting. Results Compared with CD8+ T cells cultured without SK-OV-3 , the expression of Foxp3 and CTLA-4 was increased and CD28 expression was decreased in CD8+ T cells cultured with SK-OV-3 (both P < 0.001). We found that CD8+T cells cultured with SK-OV-3 significantly suppressed the na?ve CD4+ T cell proliferation induced by the anti-CD3 stimulation in a dose-dependent manner. In contrast, CD8+ T cells cultured without SK-OV-3 did not suppress na?ve CD4+ T cell proliferation. Conclusion Ovarian cancer cell can induce the suppressive CD8+Treg, which is an important link of the immunosuppressive microenvironment in ovarian cancer.