Objective To analyze the treatment effects on the central bronchogenic carcinoma by means of interventional chemotherapy and embolization. Methods There were 60 pathologically proved cases of central bronchogenic carcinoma in mid or late period. After detecting the nourishing arteries of bronchogenic carcinoma with angiography, anticancer drugs were poured into the nourishing arteries. Then silk thread and gelform were used to embolize these arteries. Results The total effective rate of the treatment was 100% and the obvious effective rate was 80%. 33 cases were operated and chemotherapy performed after operation. 27 cases were given synthetic treatment. No one died in the follow up of 18-34 months. Conclusion Interventional chemotherapy and embolization is an effective and safe method in the treatment of central bronchogenic carcinoma. If synthetic treatment is taken, the treatment effect would be much better.

With the development of economy and society, the change of heath concept and increased demands for health care , the cultivation of postgraduates majoring in clinical medicine is facing a lot of problems which seriously affects the quality of culti-vation.The article analyzed the problems and reasons in the clinical medicine postgraduate cultivation.We stated the competency of clinical medicine postgraduates according to the transition of health demands, global medical development and practical requirements for clinical personnel in China.We elaborated the required post competence for clinical medicine postgraduates on the basis of its con-tent and characteristics.We proposed to strengthen the cultivation of clinical medicine postgraduates by the reform and support of the government, enhanced construction of teachers, improved course plan and cultivation process, perfected assessment system in order to make the students competent to their posts.

The potency and safety of thyroid artery embolization by Pingyangmycin Lipiodol Emulsion(PLE) were observed. The results suggested that PLE is a potential embolization agent in interventional therapy of hyperthyroidism with relative safety and efficacy.

Objective:To analyze the correlation between serum levels of interleukin-6 (IL-6), IL-10, whole parathyroid hormone (iPTH), C-reactive protein (CRP) and major adverse cardiac events (MACE) in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis, and to evaluate the predictive value of these indicators for the occurrence of MACE.Methods:A prospective study was conducted on 120 ESRD patients who underwent peritoneal dialysis (PD) at the Second People′s Hospital of Yichang from January 2020 to June 2022. Blood samples were collected from the elbow vein to measure serum IL-6, IL-10, iPTH, and CRP levels. Echocardiography was used to measure left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), and the comprehensive cardiac function index (Tei) was calculated. All patients were followed up until June 2023 or the endpoint event of death. They were divided into MACE group and non MACE group based on whether MACE occurred. The serum levels of IL-6, IL-10, iPTH, CRP, LVEF, LVEDV, LVESV, and Tei index were compared between the two groups; Spearman analysis was used to investigate the correlation between serum IL-6, IL-10, iPTH, CRP levels and the occurrence of MACE; We established receiver operating characteristic (ROC) curves and analyzed the value of serum IL-6, IL-10, iPTH, and CRP levels in predicting the occurrence of MACE.Results:The serum levels of IL-6, iPTH, and CRP in the MACE group were higher than those in the non MACE group, and the differences were statistically significant (all P<0.05). The difference in serum IL-10 levels between the two groups was not statistically significant ( P>0.05). The LVEF of the MACE group was lower than that of the non MACE group, while the LVEDV, LVESV, and Tei indices were higher than those of the non MACE group, with statistically significant differences (all P<0.05). The levels of serum IL-6, iPTH, and CRP are positively correlated with the occurrence of MACE ( r=0.937, 0.895, 0.699, all P<0.001); There was no correlation between serum IL-10 and the occurrence of MACE ( P=0.510). The cut-off values for predicting MACE in ESRD patients using serum IL-6, iPTH, and CRP were 2.84 pg/ml, 308.71 pmol/L, and 6.91 mg/L, respectively. The area under the curve (AUC) (95% CI) under the ROC curve were 0.611(0.514-0.702), 0.542(0.481-0.619), and 0.518(0.457-0.653), respectively. Conclusions:The occurrence of MACE in PD patients is positively correlated with serum IL-6, iPTH, and CRP levels, and IL-6, iPTH, and CRP can serve as predictive indicators for MACE occurrence in PD patients.

Objective To establish the orthotopic bladder cancer model of multidrug resistance as the human' s, and detect its resistance condition. Methods Two groups of nude rats 4-6 weeks of age were inculated with 1×107 cell of T24 or T24-ADM, following with observation and putting down their meat, drink,mental condition, urine and abdominal mass growth. Animals were sacrificed after 4 weeks later, then their bladder were weighted and measured, histopathologic assessment was performed,mdr1 was detected by PCR,and cells from the bladder tumors were detected of multidrug resistence by MTT. Results Group of nude rats inculated with T24-ADM generated tumors about 80 % (8/10), the one inculated with T24 was 90 % (9/10)and about 2-3 days early. The blank group had no rats emerge tumors in bladder mucosa at all. Bladder weight and volume: (0.8±0.3) g, (1.0±0.5) g, (875±158) mm3, (903±192) mm3, difference between the two groups had no significant (t = 1.332 and t = 1.215, P＞0.05). Histopathologic detection: The two groups of bladder cancer tissue biopsies can be seen more chaotic arrangement of cell structure, cell body shape is irregular, to the depth of myometrial invasion in different without breaking the film. Between the two groups there were no significantly differences. PCR detection of mdr1 expression differences between the two groups was significant (t = 3.612, P ＜0.01). Cytological detection of drug-resistant cell volume is slightly larger, and no significant difference in morphology. MTT detection: cells from the inculated T24-ADM mice bladder tumor were more resistance to ADM than the ones from the inculated T24 mice bladder tumor (F = 412.107, P＜0.01), and for several other drugs were also resistant. Conclusion Cell transplantation was successfully used to establish bladder cancer model in situ of T24-ADM, and with multi-drug resistance characteristics. The model laid the foundation for further multi-drug resistance research of bladder cancer.

Objective: A new ion exchange column technology was used to establish an efficient and sensitive method for the detection of inorganic arsenic. Methods: Based on the new As Specia Fast Column, the pretreatment methods, liquid phase separation and mass spectrometry determination conditions of inorganic arsenic in rice were optimized. Finally, arsenic compounds were separated by As Specia Fast Column and detected by liquid chromatography inductively coupled plasma mass spectrometry. The external standard method was used for quantitative analysis. The detection limit, precision and accuracy of the method were determined by measuring the content of arsenic compounds in rice samples and rice standard samples. At the same time, three Guangdong rice samples were selected as the experimental samples of this study, and 1 g of each sample was weighed and measured in parallel three times. The method was compared with the method of liquid chromatography-atomic fluorescence spectrometry (LC-AFS) and liquid chromatography-inductively coupled plasma mass spectrometry (LC-ICP-MS) in the national standard. Results: The inorganic arsenic in rice was extracted with 0.5% nitric acid solution at 65 ℃ for 15 h, and the pH was adjusted to alkaline. The mobile phase A (8 mmol/L HNO₃, 50 mmol/L NH₃·H₂O) and mobile phase B (40 mmol/L HNO₃, 80 mmol/L NH₃·H₂O) were used as the mobile phase gradient elution (93%) . Five arsenic compounds can reach baseline separation under the conditions of RF power of 1 500 W and atomization gas flow of 0.97 L/min. The detection limits ranged from 0.114 to 0.331 μg/L, and the inorganic arsenic content in rice samples ranged from 0.063 to 0.232 mg/kg. The results of determination of arsenic compounds in rice flour reference materials were all within the uncertainty range indicated by the standard. The recoveries were 86.7%~106.7%, and the precision was 1.9%-12.5%. Compared with national standards, the results of determination of arsenate in rice were relatively close (using this method, LC-AFS, LC-ICP-MS to detect the content of arsenate in rice samples 1 was 0.231, 0.226, 0.236 mg/kg, respectively). However, due to insufficient sensitivity, the national standard method is difficult to detect low levels of arsenic compounds (Arsenobetaine was not detected in rice sample 1). The method can detect the content of arsenobetaine in rice sample 1 was 0.023 mg/kg. Conclusion The established method can meet the requirements of inorganic arsenic determination in rice, and it is more rapid and accurate than the current national standard. It can better monitor and evaluate the content of i-As in rice, and provide accurate data for comprehensively grasping and evaluating the safety of rice consumption of residents.

Objective To discuss the endovascular interventional treatment of complicated splenic artery aneurysms(CSAA)and its clinical efficacy.Methods The clinical data of 15 patients with CSAA,who were admitted to authors'hospital to receive treatment between January 2013 and December 2022,were collected.The clinical manifestations included rupture with bleeding(n=2),splenic aneurysm originating at the proximal end of the normal splenic artery(n=3),splenic aneurysm originating from the superior mesenteric artery-splenic artery co-trunk(n=4),and splenic aneurysm originating from the celiac trunk-superior mesenteric artery co-trunk(n=6).According to the origin of the splenic aneurysm and the size of aneurysmal cavity,the following endovascular treatment methods were employed:① coil embolization of aneurysmal cavity,②combination embolization of the outflow tract,aneurysmal cavity and inflow tract,③covered stent implantation for intraluminal isolation,and ④bare stent-assisted spring coil embolization and combination therapy with multiple approaches.The medium-term and long-term efficacy of endovascular interventional treatment were analyzed.Results A total of 15 aneurysms were detected in the 15 CSAA patients,the mean diameter of aneurysmal cavity was 1.8-3.2 cm(2.5±0.4 cm),and the success rate of endovascular treatment was 100％.The mean follow-up period was(22.8±10.2)months.In 13 patients(86.7％)the splenic artery aneurysm remained thrombosis with no enlargement of the aneurysmal cavity.One patient had to receive endovascular interventional treatment as the aneurysmal cavity continued to enlarge.One patient developed covered stent occlusion as the patient did not take drugs regularly,and no hepatic or intestinal ischemia,or death occurred during the follow-up period.Asymptomatic focal splenic infarction occurred in 5 patients.Conclusion For CSAA with different anatomical variation origin,endovascular interventional treatment is clinically feasible,safe and effective.

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.