Objective　To observe the influence of pre-infarction angina on ventricular function and prognosis of first acute myocardial infarction in old people. Methods　76 first acute myocardial infarction old patients was divided into two groups: angina pectoris group (n=42); no angina pectoris group (n=34). Global left ventricular function was assessed by echocardiography, arrhythmia, cardiogenic shock, heart failure, post-infarction angina and mortality was observed in hospital. Results　The rate of cardiogenic shock and heart failure and mortality was lower in angina pectoris group (33.3% vs 58.8%; 2.4% vs 23.5%), LVEF and E/A was higher in angina pectoris group (0.52±0.056 vs 0.45±0.03,0.86±0.29 vs 0.54±0.35), P<0.05. Conclusion　pre-infarction angina possesses the protecting effects on ventricular function of first acute myocardial infarction in old people, and can improve the prognosis of first acute myocardial infarction in old people.

Objective: To investigate the possible association between globus pharyngeus and thyroid abnormalities. Methods: Forty six patients with globus pharyngeus and 50 non globus pharyngeus patients were investigated by using 7.5 MHz high resolution thyroid ultrasound. The micro abnormatities in 2 groups were compared. Results: The incidence of thyroid abnormalities in globus pharyngeus group was 58.9%(27/46),and it was significantly higher than that(18.0%,9/50)in non globus pharyngeus group( P

Objective To evaluate surgical indications and method for regional pancreatoduodenectomy combined with blood vessel reconstruction. Methods Forty-four patients underwent pancreatoduodenectomy combined with superior mesenteric vein and portal vein(smv-pv) resection and reconstruction between April 1994 and March 2001.Among them superior mesenteric artery (SMA) and hepatic artery (HA) were reconstructed in 4 and 2 cases, respectively. Partial resection of the anterior wall of the inferior vena cava was performed in one case for tumor invasion. Results The overall mortality was 7.1%,with no complications. The resected endothelium or margins of the blood vessel and pancreas were microscopically tumor free in all cases. Histological specimen examinations demonstrated adenocarcinoma of pancreas head in 43 cases, neuroendocrine adenocarcinoma was diagnosed in one case. Patients were followed-up from 3～87 months with 2 cases lost after PV/SMV for pancreatoduodectomy. Six patients have survived more than 5 yearsand 21 cases more than 3 years. Conclusion Regional pancreatoduodenectomy combined with reconstructionof blood vessel could increase tumor resection rate in properly selected patients and could be performed safely without increased morbidity and mortality.

Objective To investigate the rational method of treatment of rectal carcinoid and its outcome.Methods The clinical data of 36 cases of rectal carcinoid were retrospectively analysed.Results During a follow-up of 82.6+/-63.4 months,there were no cases with recurrence among the 20 patients with tumor size2cm.Conclusions Tumor diametar can be used to estimate the degree of malignancy of rectal carcinoid.TNM staging is simpler and practical for deciding the method of surgical treatment.

Objective To investigate the diagnosis and the relationship between its clinicopathological characteristics,treatment and the prognosis of primary colorectal lymphoma.Methods The clinical data of 20 primary colorectal lymphoma patients who received operative treatment in the past 34 years in our hospital were retrospectively summarized,and the influence of treatment and each clinicopathological factor on prognosis was assessed.Results Tumor size,lymph node metastasis,invasion of neighboring organs and distant metastasis,and type of operative treatment were significantly related to the survival(P0.05).Conclusions Diagnosis of primary colorectal lymphoma before operation is difficult,and misdiagnosis is common.Operative treatment is the main therapeutic means for colorectal lymphoma.Radical operation combined with chemotherapy can gain a good prognosis.

The poly ADP-ribose polymerase (PARP) is a class of nuclear enzymes highly expressed in eukaryotic cells and plays a key role in DNA damage repair. In recent years, PARP inhibitors have shown great potential in tumor therapy, and several PARP inhibitors have been approved by the FDA for maintenance therapy of a variety of cancers. PARP inhibitors mainly inhibit PARP enzymes and PARP trapping, resulting in the persistence of DNA single strand breaks, which are converted to double strand breaks during DNA replication. Studies have shown that PARP inhibitors not only have a significant anti-tumor effect, but also have a synergistic effect with radiotherapy. This paper reviewed the potential theoretical basis of PARP inhibitor combined with radiotherapy, summarized the recent progress of preclinical and clinical research on PARP inhibitors in tumor radiotherapy, sorted out the urgent problems in this field, and looked into the application prospect of PARP inhibitors in anti-tumor therapy.

Objective To analyze the clinical features and reasons of pressure ulcers in general hospital of western regions, and provide references for effective prevention and management of pressure ulcer. Methods Hospitalized patients who meet the conditions (≥18 year-old, hospital stay≥24 h ) in 51 wards of the largest tertiary comprehensive hospital in Ningxia were investigated by data collection tools that designed by European pressure ulcer advisory panel (EPUAP) and American survey instrument of pressure ulcer prevalence rate. For the cross-sectional survey on pressure ulcer, nurses were training and one day respectively in January and April 2015 were selected as the research day. Results Totally 3654 patients were investigated, among which there were 1894 male patients and 1760 female patients. 332 patients had the risk of pressure ulcer ( Braden score≤16 points ) , which accounted for 9.08%;31 cases and 35 parts were found with the pressure ulcer and the prevalence rate of pressure ulcer was 0.85%;the occurrence rate in hospital was 0.47%. Clinical features were mainly stage I and stage II, which accounted for 77. 42% ( 24/31 ); body parts with high occurrence of pressure ulcer were sacrococcygeal region, crista iliaca, ischial tuberosity and ankle. Implementation of prevention measures: patients with decompressor using accounted for 4. 93 among all researchers ( 180/3 654 ) , and accounted 54. 22% among patients with risk of pressure ulcer ( 180/332 );patients with dressing to reduce pressure on pressed parts that accounted 2. 49% among all researchers (91/3 654), and accounted 27.41% among patients with risk of pressure ulcer (91/332);patients with regular turning over accounted for 11. 49% among all researchers ( 330/3 654 ) , and accounted for 99. 4% among patients with risk of pressure ulcer ( 330/332 ) . Conclusions The prevalence rate and occurrence rate pf pressure ulcer in comprehensive hospitals of western area are all lower than those in researches home and abroad;the clinical features are similar to 12 comprehensive hospitals in our country, and the implementation rate of prevention measures should be improved. Nursing knowledge training of pressure ulcer in hospitals and the implementation rate of prevention measures should be enhanced.

Objective:To evaluate the effect of niraparib, the poly (ADP-ribose) polymerase (PARP) inhibitor, on the radiosensitivity of esophageal squamous cell carcinoma (ESCC) and to preliminarily investigate its mechanism.Methods:Human esophageal squamous cell carcinoma cells ECA-109 and KYSE-150 were divided into the control, niraparib, single irradiation, combined (niraparib+irradiation) groups. Cell proliferation was measured by CCK-8 assay. The changes of cell survival rate were detected by colony formation assay. The changes of cell cycle and apoptosis were analyzed by flow cytometry. The number of γH2AX foci was detected by immunofluorescence, and the expression levels of PARP-1, cleaved-PARP, RAD51, mitogen-activated protein kinase (MAPK) [extracellular signal-regulated kinase 1 and 2 (ERK1/2) ] and p-MAPK (ERK1/2) proteins were determined by Western blot. All data were expressed as Mean±SD. Data between two groups conforming to normal distribution through the normality test were subject to independent sample t-test and multiple groups were analyzed using one-way ANOVA. Results:In human ESCC cells ECA-109 and KYSE-150, the proliferation of ESCC cells was significantly inhibited by niraparib combined with irradiation, and the values of average lethal dose (D 0), quasi-threshould dose(D q), survival fraction after 2 Gy irradiation (SF 2) in the combined group were decreased compared with those in the single irradiation group. The effect of irradiation alone on apoptosis of ECA-109 and KYSE-150 cells was limited. Compared to single irradiation group, irradiation combined with niraparib further increased the apoptosis rate in ESCC cells ( P=0.015, P=0.006). In ECA-109 cells, G 2/M phase arrest was significantly increased in combined group compared with irradiation alone group ( P<0.001). In ECA-109 cells, the number of γH2AX foci in combined group was higher than that in the single irradiation group after 2 h, and showed a significantly slower decay of γH2AX foci ( P<0.001). Moreover, niraparib combined with irradiation enhanced the radiation-induced cleavage of PARP-1 and down-regulated the expression of Rad51 and p-MAPK(ERK1/2). Conclusion:Niraparib can increase the radiosensitivity of esophageal cancer cells by inhibiting cell proliferation, promoting cell apoptosis, inhibiting the repair of DNA damage and regulating the MARK-ERK signaling pathway.

Objective:Assess the 10-year Immune persistence and the predictors after primary vaccination hepatitis B vaccine (HepB) among normal and high-responder infants.Methods:A total of 1 838 Infants of 7-12 months old located in Jinan, Weifang, Yantai and Weihai of Shandong Province who were induced normal or high antibody response (anti-HBs titer ≥ 100 mIU/ml) after primary vaccination (three dose with 0-1-6 procedure) with 5 μg recombinant HepB among newborns were included in the study, in 2009. 3 ml of venous blood samples were collected at baseline survey (T 0) and antibodies against hepatitis B surface antigen (anti-HBs), antibody against hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were detected using chemiluminescence microparticle immunoassay (CMIA) method. A self-designed questionnaire was used to collect information including the infant′s age, sex, birth weight, premature birth, birth number, delivery location and mother′s HBV infection status. In 2014 (followed up for 5 years) and in 2019 (followed up for 10 years) (T 1), 2 ml of venous blood samples were collected. Anti HBS and anti HBC were detected by CMIA method. Those with anti HBS<10 mIU/ml were detected by CMIA method. Multivariate unconditional logistic and linear regression models were used to analyze the influencing factors of anti-HBs positive rate and geometric mean concentration (GMC) at T 1. Results:After 10 years follow-up, 73.94% of the subjects (1 359/1 835) finished the follow-up. 51.15% of the subjects, a total of 625 were boys. The positive rate of anti-HBs was 100% at T 0 and decreased to 53.44% (95% CI: 50.59%-56.26%) at T 1. The average annual decline rate of anti-HBs positive rate from T 0 to T 1 was 6.07%. The GMC of anti-HBs decreased from 607.89 (95% CI: 579.01-642.62) mIU/ml to 16.44 (95% CI: 15.06-18.00) mIU/ml. The average annual decline rate of anti-HBs GMC in 10-year follow-up was 30.30%. Multivariate logistic analysis showed that the positive rate of anti-HBs at T 1 was lower in those who did not vaccinate the first dose in time ( OR=0.25, 95% CI:0.07-0.71). Compared with those with GMC<1 000 mIU/ml at T 0, those with GMC ≥ 1 000 mIU/ml had a higher positive rate of anti-HBs at T 1 ( OR=2.29, 95% CI:1.76-2.97). Multivariate regression analysis showed that the GMC of anti-HBs at T 1 was lower in those who did not vaccinate the first dose in time (β=-0.50, 95% CI:-1.24-0.24). Compared with those with GMC<1 000 mIU/ml at T 0, those with GMC ≥ 1 000 mIU/ml had a higher GMC of anti-HBs at T 1 (β=0.81, 95% CI: 0.62-1.05). Conclusion:Anti-HBs GMC decreased in 10 years after primary vaccination of 5 μg recombinant hepatitis B vaccine among normal and high-responders. The anti-HBs persistence was mainly associated with whether the first dose was vaccinated in time and the level of anti-HBs at the end of primary vaccination.

Objective To investigate the effect of residual corneal astigmatism on visual acuity after regional refrac-tive intraocular lens(IOL)implantation.Methods A retrospective cohort study was conducted.The medical records and follow-up data of 73 eyes of 57 cataract patients who underwent ultrasound emulsification cataract extraction combined with LENTIS Comfort LS-313 MF15 IOL implantation in the Ophthalmology Department of the Hebei General Hospital from June 2020 to March 2022 were collected.These patients were grouped according to postoperative residual corneal astigmatism:32 patients(40 eyes)with a residual corneal astigmatism of 0.75(exclusive)-1.50 D were taken as the experimental group,and 25 patients(33 eyes)with a residual corneal astigmatism ≤0.75 D were taken as the control group.The uncor-rected distance visual acuity(5 m),uncorrected intermediate visual acuity(80 cm),uncorrected near visual acuity(40 cm),out-of-focus curve,objective visual quality,subjective visual quality,satisfaction degree and lens removal rate of pa-tients in the two groups were recorded 6 months postoperatively.Results The postoperative uncorrected distance visual acuity(logMAR)was 0.10(0.00,0.22),the uncorrected intermediate visual acuity(logMAR)was 0.00(0.00,0.10),and the uncorrected near visual acuity(logMAR)was 0.20(0.10,0.30)and 0.20(0.10,0.20)in the experimental and control groups,with no statistically significant differences(all P＞0.05).The postoperative out-of-focus curves showed that the distance visual acuity of patients with additional spherical equivalent refraction ranged from+2.00 D to-4.00 D in the two groups had no statistically significant difference(all P＞0.05).There were statistically significant differences in to-tal aberration,coma aberration,modulation transfer function and Strehl ratio in the objective visual quality of patients after surgery(all P＜0.05),and there was no statistically significant difference in the total higher-order aberration,spherical ab-erration and cloverleaf aberration(all P＞0.05).There was no statistically significant difference in the subjective visual quality,satisfaction degree and lens removal rate in the two groups(all P＞0.05).Conclusion Residual corneal astig-matism of 0.75 D to 1.50 D after LENTIS Comfort LS-313 MF15 IOL implantation has no effect on higher-order aberration,spherical aberration,and cloverleaf aberration in subjective and objective visual quality,and has an impact on total aberra-tion,coma aberration,modulation transfer function and Strehl ratio in objective visual quality.