Abstract:Objective To explore the efficacy of SOX regimen neoadjuvant chemotherapy (NAT) for advanced gastric cancer and its influencing factors. Methods The clinical data of 128 patients with advanced gastric cancer who received SOX regimen NAT (NAT group) and 128 patients with advanced gastric cancer who underwent surgical treatment without NAT (control group) in our hospital from Feb. 2010 to Apr. 2016 were analyzed retrospectively. A multivariate Cox proportional hazard regression model was used to analyze the factors affecting the overall survival, and a nomogram prediction model for predicting the efficacy of NAT was established based on related variables. Results The median survival time of patients in the NAT group was 31 months and that in the control group was 21 months. There was significant difference between the 2 groups (P<0.05). Multivariate Cox proportional hazard regression model analysis showed that age, tumor location, tumor size, carcinoembryonic antigen, carbohydrate antigen 19-9 (CA 19-9), clinical T stage, clinical N stage, lymph node metastasis and not receiving SOX regimen NAT were the independent risk factors for the prognosis of gastric cancer patients (all P<0.05). The nomogram prediction model was successfully constructed. It had been verified internally that the model had a good coincidence rate, good discrimination and accuracy. By comparing the prediction model with the TNM staging, it was found that the nomogram prediction model had high sensitivity and specificity. Conclusion SOX regimen NAT can improve the condition of patients with advanced gastric cancer. According to age, tumor size, tumor site, carcinoembryonic antigen, CA 19-9, clinical T stage, clinical N stage, lymph node metastasis and whether or not to receive SOX regimen NAT, the prediction model established by the nomogram can better predict the prognosis of advanced gastric cancer patients.

Abstract:Objective To explore the value of contrast-enhanced ultrasound (CEUS) computed tomography (CT)-Bosniak classification (refering to the update version of Bosniak classification [CT, 2019]) and CEUS Ruijin (RJ)-Bosniak classification in predicting benign and malignant cystic renal masses. Methods The CEUS images of 347 cystic renal masses from 316 patients who underwent CEUS in Ruijin Hospital or Wuxi Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from Jun. 2015 to Jul. 2020 were retrospectively analyzed. Classification according to the CT standard of Bosniak classification (version 2019) was defined as CEUS CT-Bosniak, and that of Ruijin Hospital clinical experience was defined as CEUS RJ-Bosniak. All the patients were confirmed by biopsy or surgical pathology, enhanced CT or magnetic resonance imaging (MRI). Four grid table was used to calculate the accuracy, sensitivity and specificity of the 2 CEUS Bosniak classifications in the diagnosis of benign and malignant cystic renal masses. Results In the 347 renal cystic foci, 308 benign foci and 39 malignant foci were diagnosed based on the gold standards (the pathological results of surgery or biopsy and the final clinical diagnosis). Of the 347 lesions, there were 198 cases of category Ⅰ, 45 cases of category Ⅱ, 50 cases of category ⅡF, 26 cases of category Ⅲ, and 28 cases of category Ⅳ according to CEUS CT-Bosniak classification; 198 cases of categoryⅠ, 28 cases of category Ⅱ, 66 cases of categoryⅡF, 28 cases of category Ⅲ, and 27 cases of category Ⅳ according to CEUS RJ-Bosniak classification. Whith Bosniak categories Ⅲ and Ⅳ as diagnostic criteria of malignant foci, 290 benign and 36 malignant foci were correctly diagnosed by CEUS CT-Bosniak classification, while 292 benign lesions and 38 malignant foci were correctly diagnosed by CEUS RJ-Bosniak classification. The accuracy, sensitivity, specificity, and positive and negative predictive values between the diagnostic results of CEUS CT-Bosniak and CEUS RJ-Bosniak classification were 93.95% (326/347) and 95.10% (330/347), 92.31% (36/39) and 97.44% (38/39), 94.16% (290/308) and 94.81% (292/308), 66.67% (36/54) and 70.37% (38/54), and 98.98% (290/293) and 99.66% (292/293), respectively. The diagnostic results of the 2 standards were highly consistent with the gold standard results (Kappa values were 0.74 and 0.79, respectively). Conclusion CEUS combined with Bosniak classification has high value in differential diagnosis of benign and malignant renal cystic masses. RJ-Bosniak classification is simple and effective, which is worthy of clinical application.

Abstract:Objective To investigate the impact of hepatitis B virus (HBV) infection on the prognosis of intrahepatic cholangiocarcinoma (ICC). Methods The data of 162 patients with ICC histologically proven by surgery or biopsy in Anting branch of our hospital from Oct. 2015 to Dec. 2019 were retrospectively analyzed. The general information and prognosis of patients with HBV-related ICC (55 cases) and non-HBV-related ICC (107 cases) were compared. Cox proportional hazard regression model was used to analyze the independent factors affecting the prognosis of ICC patients. Results The median survival time of patients in HBV-related ICC group and non-HBV-related ICC group were 26 and 28 months, and the 1-, 3- and 5-year overall survival rates were 80.0%, 29.8%, 14.5% and 79.3%, 31.2%, 16.6%, and the 1-, 3- and 5-year progression-free survival rates were 59.0%, 21.5%, 14.3% and 52.6%, 20.9%, 13.1%, respectively. There were no significant differences in overall survival rate or progression-free survival rate between the 2 groups (P=0.487, 0.634). Stratified analysis by HBV-DNA levels showed no significant difference in overall survival rate or progression-free survival rate between patients with HBV-related ICC in the HBV-DNA≤50 IU/mL group and HBV-DNA>50 IU/mL group (P=0.643, 0.535). Multivariate Cox proportional hazards regression analysis showed that TNM stage Ⅳ (hazard ratio [HR]=3.12, 95% confidence interval [CI] 1.57-6.20, P=0.001), radical surgery (HR=0.47, 95% CI 0.26-0.87, P=0.016) and lymph node metastasis (HR=2.10, 95% CI 1.31-3.36, P=0.002) were the independent influencing factors of overall survival in ICC patients. Conclusion HBV infection has no significant effect on the prognosis of ICC patients. Radical surgery is an independent protective factor for overall survival of ICC patients, and TNM stage Ⅳ and lymph node metastasis are the independent risk factors.

Abstract:Objective To analyze the allergen detection results in patients with allergic rhinitis under 18 years old in Zhangjiakou area, and to understand the distribution of food and inhalant allergens in patients with allergic rhinitis in this area. Methods Totally 454 patients with clinical manifestations of allergic rhinitis under 18 years old who visited the Department of Otolaryngology, Head and Neck Surgery of the First Affiliated Hospital of Hebei North University from Apr. 2019 to Nov. 2020 were selected. The sera of patients were detected for 15 types of allergens to specific immunoglobulin E (sIgE) by enzyme-linked immunosorbent assay (ELISA) and the differences of allergens in different ages, genders and months of treatment were analyzed. Results Of the 454 patients, 438 were positive for at least 1 allergen (the positive rate was 96.48%), and the positive rate of inhalant allergens was 71.59% (325/454). The most prevalent inhalant allergen was mugwort (52.20%, 237/454), followed by common ragweed (28.85%, 131/454) and house dust (28.85%, 131/454). The positive rate of food allergens was 67.18% (305/454), the most universal food allergens were egg (55.51%, 252/454) and milk (34.14%, 155/454). There were significant differences in the total positive rates of allergens, inhalant allergens and food allergens among the 1-6 years old group, 7-14 years old group and 15-17 years old group (P<0.01). The positive rate of inhalant allergens in 1-6 year old group was lower than that in 7-14 year old group (χ²=18.897, P<0.001), but there were no significant differences between 15-17 year old group and 1-6 year old group or 7-14 year old group (χ²=3.959, P=0.047; χ²=0.818, P=0.366); the positive rate of food allergens in 1-6 year old group was higher than that in 7-14 year old group and 15-17 year old group, and the positive rate in 7-14 year old group was significantly higher than that in 15-17 year old group (all P<0.001). Further comparative analysis showed significant differences in the positive rates of mugwort, common ragweed, cat epithelium, willow, house dust, house dust mite, dust mite, egg and milk among the 3 age groups (all P<0.05). The positive rates of allergens in mugwort, common ragweed, cat epithelium and Streptomyces alternaria in male AR patients were higher than those in female AR patients (all P<0.05). AR patients were mainly sensitized by single allergen (29.45%, 129/438), and the number of positive allergens was not related to the gender. The visit number of AR patients peaked in August (37.22%, 169/454). Conclusion The main inhalant allergens of AR patients under 18 years old in Zhangjiakou area are mugwort, common ragweed and house dust, and the food allergens are eggs and milk. With the increase of patients’ age, the positive rates of food allergens decrease. The patients are mainly sensitized by single allergen and the visit number of AR peaks in August.

Abstract:Objective To analyze the biological characteristics of intestinal flora in hypothyroidism patients with abnormal thyroperoxidase antibodies (TPOAb) in the third trimester of pregnancy and their correlations with maternal and infant outcomes. Methods A total of 40 hypothyroidism patients in the third trimester of pregnancy (20 with abnormal TPOAb level [>35 IU/mL] and 20 with normal TPOAb level [≤35 IU/mL]) who visited in the Department of Obstetrics of our hospital from Sep. 2018 to Oct. 2019 were selected. The species and relative abundance of intestinal flora between the 2 groups were compared by 16S rRNA sequencing, and Bifidobacterium and Lachnospira were quantitatively analyzed by quantitative real-time ploymerase chain reaction (qRT-PCR). In addition, the serological test indexes and maternal and infant clinical indexes of the 2 groups were compared, and the correlation between maternal intestinal flora and maternal and infant outcomes was analyzed. Results 16S rRNA sequencing showed that the relative abundance of Bifidobacterium in the intestinal flora of TPOAb positive pregnant women was increased, while the relative abundance of Lachnospira was decreased. qRT-PCR analysis also confirmed this change. The results of serological indexes showed that the levels of C reactive protein (CRP), interleukin (IL)-2 and IL-6 before delivery and the level of CRP after delivery were significantly higher in the TPOAb positive group than in the TPOAb negative group (all P<0.05). Correlation analysis showed that the relative abundance of Bifidobacterium was positively correlated with the serum TPOAb level (r=0.55, P<0.01), and the relative abundance of Lachnospira was negatively correlated with the serum IL-6 level (r=－0.37, P=0.02). The times of previous embryo suspension and spontaneous abortion of the TPOAb positive group were significantly higher than those of the TPOAb negative group (P=0.04 and 0.02). The neonatal weight and head circumference of the TPOAb positive group were significantly lower than those of the TPOAb negative group (both P<0.01), and the incidences of neonatal asphyxia and neonatal distress during delivery were significantly higher than those of the TPOAb negative group (both P=0.04). Conclusion The abnormal TPOAb of hypothyroid pregnant women in the third trimester of pregnancy is closely related to the intestinal flora and poor maternal and infant outcomes. Intestinal Bifidobacterium and Lachnospira may be noninvasive biomarkers for abnormal TPOAb in pregnant women with hypothyroidism in the third trimester of pregnancy.

Abstract:Objective To observe the expression of dipeptidyl peptidase 3 (DPP3) and heme oxygenase 1 (HO-1) in cardiac tissues of ovariectomzied (OVX) rats, and to explore the role of DPP3 in 17β-estradiol (E2)-improving stress. Methods OVX operated postmenopausal rats were used as experimental animal models, supplemented with E2 for 4 weeks as the main intervention. The rats were randomly divided into 4 groups according to the presence or absence of OVX and supplementary E2. They were named sham operation control group (Sham)＋Vehicle (Veh) group, Sham＋E2 group, OVX＋Veh group and OVX＋E2 group, with 5 rats in each group. The ratio of heart weight to body weight, mean arterial pressure (MAP), heart rate (HR), maximum rate of rise of left ventricular pressure (dp/dt_max), and the maximum rate of drop of left ventricular pressure (－dp/dt_max) of each group were measured. The levels of oxidative stress in cardiac tissues were detected by enzyme-linked immunosorbent assay (ELISA), and the expression levels of DPP3 and HO-1 were detected by Western blotting. Results Compared with the Sham+Veh group, the ratio of heart weight to body weight, MAP and HR were significantly increased, and the absolute values of maximum rate of rise of left ventricular pressure dp/dt_max and －dp/dt_max were significantly decreased in the OVX＋Veh group (all P<0.05); after E2 supplementary treatment, the ratio of heart weight to body weight, MAP and HR were significantly decreased, and the absolute values of dp/dt_max and －dp/dt_max were significantly increased in the OVX＋E2 group than in the OVX＋Veh group (all P<0.05). Compared with the Sham＋Veh group, the activities of antioxidant enzymes (catalase and superoxide dismutase) and the expression levels of DPP3 and HO-1 were significantly decreased, and the levels of reactive oxygen species and malondialdehyde were significantly increased in the OVX＋Veh group (all P<0.05); after 4 weeks of E2 supplement, the effects induced by OVX were improved (all P<0.05). Conclusion The expression of DPP3 and HO-1 is decreased in cardiac tissues of OVX rats, and can be increased by E2 supplement, showing a cardioprotective effect.

Abstract:Objective To establish a new mouse model of common carotid artery remodeling by silicone microcatheter cannula constriction, and to analyze the relationship between vascular constriction time and vascular remodeling. Methods Twelve C57BL/6 mice were anesthetized with isoflurane. The median cervical incision was taken to separate the left and right common carotid arteries. The left common carotid artery was constricted by a silicone microcatheter (1 cm in length and 0.3 mm in internal diameter), which was longitudinally cut and inserted into the common carotid artery, fixed and tied tightly; the right common carotid artery received sham operation without silicone microcatheter and constriction. Six mice were sacrificed at 2 and 4 weeks after operation, 3 for histopathological observation and 3 for RNA and protein extraction. Pathological sections were made from both common carotid arteries of mice. The microstructure of common carotid arteries was observed by hematoxylin-eosin (H-E) staining, and the expression of proliferating cell nuclear antigen (PCNA) in vascular smooth muscle cells of common carotid arteries was detected by immunohistochemical staining; RNA and protein samples were extracted from both common carotid arteries, the expression of molecular markers (calponin 1 [CNN1] and actin alpha 2, smooth muscle [ACTA2]) for smooth muscle cell phenotype switches was detected by quantitative real-time polymerase chain reaction (qRT-PCR), and the expression of proliferation markers (cyclinA2, cyclinD1 and PCNA) was detected by Western blotting. Results The left common carotid artery cannula constriction was successfully performed in all the 12 mice. The vascular lumen stenosis was observed immediately after the cannula was tightened, but the blood flow was not blocked. There were no obvious abnormal manifestations in the mice at 2 or 4 weeks after operation. H-E staining showed that the adventitia of the left common carotid artery proliferated significantly at 2 weeks, and the intima and media of the left common carotid artery proliferated significantly at 4 weeks. Immunochemical staining revealed abundant PCNA expression in the left common carotid artery at 2 and 4 weeks after operation, suggesting abnormal proliferation of smooth muscle cells. Additionally, qRT-PCR showed that the expression levels of contraction markers of smooth muscle cells (CNN1 and ACTA2) in the left common carotid artery were significantly decreased at 2 and 4 weeks after operation. Western blotting showed that the expression levels of the proliferation markers (cyclinA2, cyclinD1 and PCNA) were all increased in the left common carotid artery at 2 and 4 weeks after operation. Conclusion The constriction of common carotid artery with a silicone microcatheter cannula is a simple and efficient method for the construction of vascular remodeling model.

Abstract:Objective To prepare multifunctional nanoparticles targeting thrombus, and to explore the physico-chemical properties, targeting effect, photoacoustic imaging ability and thrombolytic effect of the nanoparticles. Methods cCGPRPPC-DiR-PFP-PLGA nanoparticles (TNP) were prepared by double emulsification method and modified by carbodiimide technique, with poly(lactic-co-glycolic acid) (PLGA)，near-infrared fluorescent iodide (1,1’-dioctadecyl-3,3,3’,3’-tetramethylindotricarbocyanine iodide, DiR), perfluoropentane (PFP) and cCGPRPPC cyclic peptide. The morphology, particle size, zeta potential and polydispersity were observed by optical microscope and laser particle size analyzer; the encapsulation rate of DiR was detected by ultraviolet spectrophotometer; the conjugation of cyclic peptide with nanoparticles was detected by confocal microscopy and flow cytometry; the targeting properties of TNP were observed by confocal microscopy and fluorescence microscopy; the imaging ability of TNP was analyzed by photoacoustic imaging experiments; and TNP were used for thrombolysis in vitro and in vivo with low-intensity focused ultrasound (LIFU) irradiation. Results The particle was round, the size of TNP was (262.67±23.46) nm, the zeta potential was (－1.97±0.68) mV, the polydispersity index was 0.06±0.05, the DiR encapsulation rate was (82.00±0.03)%, and the conjugation rate of peptide with nanoparticles was (99.58±0.47)%. The photoacoustic signal intensity of TNP in vitro was concentration dependent. TNP could target thrombus both in vitro and in vivo. In vitro, the thrombolytic rate was (71.43±1.00)% at 30 min after LIFU irradiation. In vivo thrombolysis experiment, the photoacoustic signal intensity of thrombus decreased with the prolongation of LIFU irradiation time. Conclusion Thrombus targeting contrast agents, TNP, have been successfully prepared, which exhibiting photoacoustic imaging ability and thrombolytic effect in vitro and in vivo.

Abstract:Objective To develop a trauma and stress exposure scale for peacekeepers and to evaluate its reliability and validity. Methods The theoretical and structural models of the scale were determined based on literature review and interview, and an item pool was established, which was revised by experts to form basic items. In Oct. 2019, 733 soldiers and officers from 2 peacekeeping infantry battalions to South Sudan were tested, items were screened through project analysis, and basic scale was formed by exploratory factor analysis. A confirmatory test was conducted on 595 officers and soldiers of another peacekeeping infantry battalion to South Sudan in Jan. 2020. The reliability of the scale was verified by the Cronbach’s α coefficient and the split-half reliability test scale, and the validity was verified by correlation analysis and confirmatory factor analysis. The post-traumatic stress disorder (PTSD) check list-military version (PCL-M) scale was used as the calibration table to test the calibration correlation validity, and the predictive validity of the scale was evaluated by ROC curve. Results The scale finally included 25 items in 5 factors (traumatic events during peacekeeping, personal life stressors, interpersonal stressors, task evaluation and past traumatic events), with an overall cumulative contribution rate of 62.909%. Confirmatory factor analysis showed that the Cronbach’s α coefficient was 0.909 for homogeneity reliability and 0.806 for the split-half reliability of the whole scale. In the structural validity test, all the fitting indexes were in the ideal standard range (χ²/df=2.438, root mean square residual=0.042, and root mean square error approximation=0.082). The score of each dimension was positively correlated with the total score (r=0.411-0.727, all P<0.01). The calibration correlation validity between the total scores of the scale and the PCL-M scale was 0.623 (P<0.01). The predictive validity of the scale was calculated at 5%, and the area under curve was 0.937 (95% confidence interval 0.907-0.967). Conclusion The trauma and stress exposure scale for peacekeepers has been preliminarily developed after strict item selection. The items of the scale are in line with the principles of good representativeness, high sensitivity and good differentiation, and meet the requirements of the development.

Abstract:The changes in intracranial pressure can timely and accurately indicate the physiological and pathological changes. Therefore, scientific and reasonable intracranial pressure monitoring can provide an effective basis for the prevention and treatment of craniocerebral diseases. Two main methods for intracranial pressure monitoring are invasive intracranial pressure monitoring and noninvasive intracranial pressure monitoring. Invasive intracranial pressure monitoring has been regarded as the golden standard due to its high accuracy, but its application is limited for its high cost and many complications. To seek a cheap, reliable, widely applicable intracranial pressure monitoring method with few complications, scientific researchers and clinical workers have worked hard for various noninvasive intracranial pressure monitoring methods. This paper briefly reviews the methods, mechanisms, current situation, advantages and disadvantages of related products and research trends of many noninvasive intracranial pressure monitoring ways developed in recent years.

Abstract:Pedicle screw fixation has been proven to be a reliable technique in spinal surgery. It has been widely used, but the incidence of related complications increased, such as rupture, perforation and anatomical damage of important nerves and blood vessels. Scholars have adopted some auxiliary technologies and methods to improve its safety and reliability, such as electrophysiological monitoring technology, intraoperative fluoroscopy and computer tomography. Although these technologies are helpful to some extent, they all have certain limitations in clinical practice. Electronic conductivity device (ECD) is a new free-hand detection device, which can detect iatrogenic fracture of pedicle wall in real time. This review mainly introduces the structure and mechanism of ECD and its advantages and disadvantages in spinal surgery.

Abstract:With nearly 20 years of improvement and development, dual fluoroscopic imaging system (DFIS) has become a proven technique for biomechanical study. This paper reviews the relevant literature and introduces the development history, main structure and function of DFIS. DFIS has been widely used in biomechanical study of knee joint with the advantages of non-invasive, precision and dynamic observation. Therefore, this paper also summarizes the application progress of DFIS in normal knee joint and knee joint postoperative biomechanical research, and looks forward to the possible research direction in the future.

Abstract:Myofascial pain syndrome is a common clinical local pain syndrome with high incidence, and there is no radical treatment at present. As a safe, non-invasive and non-pharmacological therapy, exercise therapy plays an important role in the treatment of this disease. Exercise therapy includes active exercise (aerobic exercise, stretching exercise, myofascial self-release training), passive exercise (manual compression, device assistance, intramuscular effect sticking), traditional Chinese medicine exercise, and comprehensive therapy. This article reviews the clinical research progress of exercise therapy in the treatment of myofascial pain syndrome.

Abstract:Team process is a key point in the study of military isolated and confined environments and the primary problem is the measurement of team performance and personal contextual performance. It is difficult to carry out the traditional measuring methods in military isolated and confined environments, which are time-consuming, labor-consuming, inaccurate and subjective. The application of unobtrusive measuring methods, especially the application of sociometric badges, can solve the above problems. At present, sociometric badges already can predict personality, team performance and team process-related characteristics. Although sociometric badges have the disadvantages of low discrimination validity, low content validity, and difficulty in measuring individual contribution to the team, their portability, non-invasiveness, feedback and automaticity almost guarantee their future in military isolated and confined environments.

Abstract:Objective To explore the clinical value of blunt separation method in reducing complications related to ultrasound-guided modified Seldinger technique (MST) peripherally inserted central catheter (PICC). Methods A total of 230 patients receiving PICC were randomly divided into observation group and control group (115 cases in each group) according to the random code generated by the random number table. The observation group was treated with blunt separation, while the control group was treated with scalpel. The success rates of one-time puncture, one-time catheterization and catheterization, the degree of intraoperative pain, and the incidence of errhysis and drug leakage at puncture site were compared between the 2 groups. Results There were no significant differences in gender, age, primary tumor source, or puncture blood vessel between the observation and control groups (all P>0.05). All patients were successfully catheterized. The success rate of one-time puncture was 95.7% (110/115) in the observation group and 94.8% (109/115) in the control group, with no significant difference (P=0.757). The successful rate of one-time catheterization was higher in the observation group (100.0%, 115/115) than in the control group (93.0%, 107/115), showing significant difference (P=0.007). The degree of pain during puncture and the incidence of errhysis were lower in the observation group than in the control group (both P<0.01). No exudation occurred in the observation group after catheterization, and a little exudation occurred in 4 cases (3.5%) of the control group (P=0.122). Conclusion The blunt separation method can improve the successful rate of one-time catheterization, relieve pain and reduce the incidence of errhysis at puncture site, making it worthy of clinical application.

Abstract:Objective To investigate the safety and efficacy of Onyx combined with coil embolization in the treatment of traumatic carotid cavernous fistula (TCCF), and to summarize the treatment experience. Methods The data of 50 patients with Barrow type A TCCF who received Onyx combined with coil embolization in our center from Jan. 2009 to Jun. 2020 were retrospectively analyzed. The imaging and clinical results were evaluated after treatment. The prognosis was evaluated by clinical and imaging follow-up. Results There were 27 males (54%) and 23 females (46%) in 50 TCCF patients, with an average age of (45±15) years (range, 17-78 years). The patients had varying degrees of symptoms (exophthalmos, bulbar conjunctival congestion, limited eye movement, intracranial murmurs, etc.). The fistulas disappeared in 46 cases (92%) immediately after the procedure, and little residuals were found in 4 cases (8%). The related symptoms were relieved or disappeared to different extents. Perioperative complications occurred in 2 patients (4%). The follow-up duration was 4 (2-9) months. During the follow-up period, fistulas completely disappeared in all patients and the remaining symptoms also disappeared, except for 3 cases of visual impairment and 1 case of ophthalmoplegia. Conclusion Onyx combined with coil embolization is safe and effective in the treatment of TCCF, and it is one of the ideal ways to treat TCCF.

Abstract:Objective To investigate the short-term efficacy and safety of AccuTarget cryoablation in the treatment of early primary hepatocellular carcinoma. Methods A total of 23 patients with early primary hepatocellular carcinoma who underwent CT-guided AccuTarget cryoablation in the Department of Oncology of Longhua Hospital, Shanghai University of Traditional Chinese Medicine from Jan. 1, 2017 to Jun. 30, 2019 were recruited. The imaging information during cryoablation, adverse reactions, postoperative recurrence, and deaths were recorded to evaluate the ablation, postoperative complications, progression-free survival and 1-year overall survival rate of the early primary hepatocellular carcinoma treated with AccuTarget cryoablation. Results Among the 23 patients, 21 achieved the ice hockey complete coverage of the tumor during AccuTarget cryoablation, 2 cases had incomplete coverage, and the complete ablation rate was 91.3% (21/23). The progression-free survival was 12.0 (7.0, 12.0) months, and the 1-year overall survival rate was 95.7% (22/23). Kaplan-Meier survival analysis showed that the sum of tumor diameter and postoperative complications were related to the progression-free survival after AccuTarget cryoablation (both P=0.028). Multivariate Cox regression analysis showed that the sum of tumor diameter and postoperative complications were independent factors of the progression-free survival after AccuTarget cryoablation (both P<0.05). No obvious abnormality of the liver function was found in the 23 patients, 3 patients had a small amount of ascites, 2 patients had a small amount of hemoptysis, and no serious complications occurred. Conclusion AccuTarget cryoablation is safe and effective in the treatment of early primary hepatocellular carcinoma.

Abstract:Objective To investigate the clinical efficacy of arthroscopic debridement and cruciate ligament reconstruction in the treatment of gouty anterior cruciate ligament (ACL) pathological injury. Methods The data of 22 patients with arthroscopic reconstruction in the treatment of gouty ACL pathological injury, who visited Beijing Chao-Yang Hospital of Capital Medical University from Jan. 2015 to Jan. 2020, were retrospectively analyzed. All patients met the diagnostic criteria of gout and had clinical symptoms such as redness and swelling of the knee joint, pain and limited activity. Magnetic resonance imaging (MRI) indicated that the continuity of anterior cruciate ligament was lost or blurred. The efficacy was evaluated by Lysholm score and Kujala score before operation and at different follow-up points after operation, and the complications were recorded. Paired t-test was used to compare the preoperative and postoperative scores. Results All the 22 patients were males, aged from 19 to 56 years, with an average age of (32.4±5.1) years, and with 10 lesions on the left and 12 on the right. All the patients received functional exercise according to the rehabilitation plan. The follow-up duration was 3-48 months. The Lysholm scores and Kujala scores of patients at different follow-up points after operation were significantly higher than those before operation, and there were significant differences in the scores at 1 month, 3 months, 6 months and 12 months after operation compared with those before operation (all P<0.05). Conclusion For patients with gouty ACL pathological injury, early anterior cruciate ligament reconstruction can achieve satisfactory clinical results and improve patients’ physical exercise ability.

Abstract:Objective To investigate the distribution and drug resistance of pathogens in bronchoalveolar lavage fluid (BALF) samples in our hospital, so as to provide reference for clinical rational drug use. Methods Pathogens were isolated and identified from 615 BALF samples between Jan. 2016 and Dec. 2019 in our hospital, and drug sensitivity test in vitro was conducted. Results A total of 707 non repetitive pathogens were detected, including 593 (83.9%) Gram-negative bacilli and 114 (16.1%) Gram-positive bacilli. The top 3 pathogens were Pseudomonas aeruginosa (171 strains, 24.2%), Klebsiella pneumoniae (147 strains, 20.8%) and Acinetobacter baumannii (97 strains, 13.7%), respectively. Among the Gram-negative bacilli, Pseudomonas aeruginosa had a higher resistance rate to carbapenems, while the resistance rates to imipenem and meropenem were 33.3% (57/171) and 30.6% (52/170), respectively; Klebsiella pneumoniae had a lower resistance rate to carbapenems (<20%), the extended-spectrum β-lactamase (ESBL) production strains in Klebsiella pneumoniae was 16.3% (24/147); and Acinetobacter baumannii had a higher resistance rate of 85.6% (83/97) to imipenem and meropenem. Among the Gram-positive bacilli, the resistance rate of Staphylococcus aureus to penicillin was 89.4% (76/85). Gram-positive pathogens were not yet resistant to vancomycin and linezolid. The detection rate of methicillin-resistant Staphylococcus aureus was 32.9% (28/85). Conclusion The main pathogens isolated from BALF samples in our hospital are Gram-negative bacilli, and their drug resistance can not be ignored. The detection of pathogens in BALF has high clinical value for disease diagnosis and rational use of antibiotics.

Abstract:Objective To explore the mediating effect of pre-sleep hyperarousal between bedtime mobile phone use and subjective sleep quality among military university students. Methods Totally 565 military university students were collected by cluster sampling, and were investigated by self-designed questionnaire, Pittsburgh sleep quality index (PSQI) scale and pre-sleep arousal scale (PSAS). Pearson correlation analysis and Spearman correlation analysis were used to test the correlation between the variables, and Bootstrap test was used to test the mediating effect between Pre-sleep hyperarousal and subjective sleep quality. Results A total of 553 valid questionnaires were collected, and the effective rate was 97.88%. Among the 553 military students, 81.56% (45 cases) used mobile phones at most time or always before bedtime. Bedtime mobile phone use was positively correlated with the total score of PSQI scale (r=0.255, P<0.01) and the total score of PSAS (r=0.216，P<0.01). Pre-sleep hyperarousal partially mediated the association between bedtime mobile phone use and subjective sleep quality, which accounted for 42.86% of the total effect (P<0.01). Conclusion Pre-sleep hyperarousal partially mediates the relationship between bedtime mobile phone use and subjective sleep quality among military university students.

Abstract:Objective To understand the current status of basic research and clinical translation in the field of stem cells in recent 5 years, so as to provide reference for the development of related disciplines. Methods (1) Basic research on stem cells: stem cell related literatures published between 2015 and 2020 were retireved from Web of Science Core Collection datebase on May 15, 2020, 1 954 highly cited papers and hot papers in this filed were selected, and keyword analysis and cluster analysis were conducted through CiteSpace. (2) Clinical research: the data were searched on ClinicalTrials.gov, and official websites of the Center for Drug Evaluation of National Medical Products Administration and China Medicinal Biotech Association on May 23, 2020, summarized and sorted by Excel 2007. Results For basic research, “expression”, “differentiation”, “ pluripotent stem cell ”, “ T cell ” and “ progenitor cell ” were focuses of stem cell research, and they were clustered into 7 themes: “ embryonic stem cell ”, “ cancer stem cell ”, “ versus-host disease ”, “ cell-derived exosome ”, “ bone tissue engineering”, “ clonal hematopoiesis ” and “ traumatic brain injury ”. For clinical research, 5 506 stem cell related clinical trials were retrieved worldwide, including 482 in China. There were 18 stem cell products approved for marketing in the world, mainly focusing on mesenchymal stem cells, and domestic stem cell products were still in the stage of clinical trial. Of the 73 stem cell clinical research projects registered in China, about 2/3 (49 projects) were mesenchymal stem cell related projects, 33 projects (45.2%) involved umbilical cord derived mesenchymal stem cells. The main types of diseases included psoriasis, lupus nephritis, acute myocardial infarction, osteoarthritis, etc. Conclusion We should pay attention to the stem cell research focuses and its 7 focus areas. The stem cell products which have been approved to the world market and the clinical studies of stem cells carried out in China are mostly focused on mesenchymal stem cells.

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