Objective To analyze the effect of high quality nursing in gastroscopy examination. Method 1 300 pa﹣tients underwent gastroscopy from March 2014 to June 2014 were randomly divided to control group (n= 650) and intervention group (n= 650). Patients in control group received routine nursing, and patients in intervention group received high quality nursing intervention besides the routine nursing. Patients anxiety level, open state of esophageal meatus, one-time intubation success rate, and time-consumed in gastroscopy of the two groups were compared. Result Anxiety score between the two groups at the time of reservation was not statistically significant (P> 0.05), anxiety scores of the intervention group (31.40 ± 4.20) was lower than that of control group before gas﹣troscopy, and the difference was statistically significant (P<0.01). Open rate of esophageal meatus, one-time intuba﹣tion success rate, and time-consumed in gastroscopy of the intervention group (97.1%, 95.1%and 4.52 ± 1.23 min) were significantly better than those of the control group (79.4%, 82.3%and 5.42 ± 1.53 min). Conclusion The high quality nursing in gastroscopy can alleviate the anxiety level of patients, improve the success rate of gastroscopy, re﹣duce the pain of patients, and it is worthy of clinical promoting.

Purpose:To evaluate the treatment results of induction chemotherapy followed by radiotherapy in patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma.Methods:Fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma were treated by induction chemotherapy followed by definitive radiation therapy (CT/RT group). This group was matched with a group of fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma treated with radiotherapy alone (RT group). Results: The 5 year loco regional control was 61.2% for the CT/RT Group and 68.7% for the RT Group; The 5 yera distant metastasis was 15.2% for the CT/RT group and 27.1% for the RT Group; The 5 year distant metastasis for the patients with stage N 2 and N 3 disease was 27.4% for the CT/RT Group and 43.8% for the RT Group respectively; The overall 5 year survival (OS) was 57.8% for the CT/RT group and 51.6% for the RT group( P =0 61); The 5 year OS of N 2 and N 3 patients was 60.6% for the CT/RT group and 26.3% for the RT group( P =0 033);The 5 year OS of T 3 and T 4 patients was 36.8% for the CT/RT group and 41.2% for the RT group ( P =0 80) respectively. There were no significant differences in the incidence of acute mucositis between the two groups during radiotherapy, the side effects in leukopenia, nausea, vomiting were higher in CT/RT group than in RT group. No Grade 3 or higher late complications were observed in both groups. Conclusions:Induction chemotherapy followed by definitive radiation therapy did not improve the 5 year survival and loco regional control for the stage Ⅲ and Ⅳ nasopharyngeal carcinoma, but reduced the distant metastasis for the stage N 2 and N 3 patients; The overall 5 year survival rate for the patients with N 2 and N 3 nasopharyngeal carcinoma was improved by induction chemotherapy followed by radiotherapy. [

Objective To study the influence of PYLL on life span of residents. Methods The reduce of potential life span in Kunshan residents from 1982～1999 was analysed between the male and female. Results The life span reduced significantly in injury, poisoning and c ancer, which accounted for over 56% of total causes o f death in PYLL, especially, over 60 % in male. PYLL rate in male was higher than that in female. PYLL rate in male a nd female (except brain blood vessel disease) from 1991～1999 was lower than tha t from 1982～1990. It was consistent with increasing of old age population pr oport ion and prolonging of expected life span in Kunshan residents year by year. Conclusions The reasons that causes to death of residents were injury a nd poisoning and cancer.

ObjectiveTo observe the effects of different angles between tibial tunnel and tibial platform on “killer turn” in posterior cruciate ligament (PCL) reconstruction,and primarily discuss a safe and reasonable tunnel technology. Methods Eighteen fresh tendon grafts were used to reconstruct the PCL on the tibial side of fresh cadavers.The tibial tunnels of all specimens were built via anteromedial approach.Based on the different angles between tibial tunnel and tibial platform,all specimens were divided into Group A (30°),Group B (40°) and Group C (50°),with six specimens in each group.Area of tibial tunnel exit,pressure of tibia tunnel exit and circulation characteristics of tendons under the cyclic load before and after biomechanical test were recorded.ResultsThe area of tibial tunnel exit had statistical difference among three groups after the test ( F =8.80,P ＜ 0.05 ).The pressure of tibial tunnel exit had statistical difference among three groups (F =3.91,P ＜ 0.05 ).The cyclic frequency and fatigue strength of the transplanted tendons had statistical difference among three groups under the same cyclic load ( 256 N ) and same frequency ( 126 Hz ) ( F =4.25,P ＜ 0.05 ).Conclusions The angle between tibial tunnel and tibial platform has negative correlation with the area and pressure of tibial tunnel exit,and has positive correlation with the cyclic frequency and fatigue strength of the transplanted tendons under cyclic load.The ideal anatomy position of the tibial tunnel is the anteromedial tunnel with the angle of 40° between the tibial tunnel and the tibial platform.

Objective:To summarize the clinical features of epilepsy and (or) developmental delay associated with KCNB1 gene variants in children.Methods:A case series study was conducted on 24 children with KCNB1 gene variants associated with epilepsy and (or) developmental delay who were treated at the Children′s Medical Center of Peking University First Hospital and the Department of Neurology of Shenzhen Children′s Hospital from July 2015 to June 2024. The manifestations of seizures, electroencephalogram (EEG) and genetic test results of those children were analyzed.Results:All the KCNB1 gene variants were de novo, involving 20 different variation, including 15 missense variations, 3 frameshift variations and 2 nonsense variations. There were 7 novel variations. Among the 24 developmental and epileptic encephalopathy children, there were 14 boys and 10 girls. The last follow-up age ranged from 9 months to 13 years and 9 months. Seizures were present in 21 children (88%), with onset ranging from 1 month to 7 years, and 76% (16/21) began before 2 years of age. The seizure types included focal seizures in 15 children (71%), epileptic spasms, myoclonic seizures, and generalized tonic-clonic seizures in 6 children respectively, atypical absence seizures in 4 children, and myoclonic atonic seizures in 1 child. Seventeen children (81%) had a cluster of seizures and 5 had a history of focal status epilepticus with impaired consciousness. All 24 children had varying degrees of developmental delay, with 3 presenting solely developmental delay. EEG abnormalities were present in all the 21 children with seizures, including focal or multifocal discharges in 20 children, generalized discharges in 10 children, hypsarrhythmia in 2 children, and electrical status epilepticus during sleep in 3 children. Magnetic resonance imaging abnormalities were found in 5 of the 24 children. Among the 21 children with seizures, 57% (12/21) achieved seizure control.Conclusions:KCNB1 gene variants are predominantly de novo missense variation. Most affected children present with epilepsy, though some may exhibit only developmental delay. Epilepsy often begins before 2 years of age, with focal seizures being the most common type. About 80% of patients experience clustered seizures. Although most patients achieve seizure control, they still exhibit varying degrees of developmental delay, consistent with developmental epileptic encephalopathy.

Objective: To explore the predictive value of minimal residual disease (MRD) level in Ph-negative precursor B-acute lymphoblastic leukemia (ALL) patients. Methods: De novo 193 Ph-negative B-ALL patients from Sep 2010 to Nov 2017 were involved in the study. The patients' MRD evaluation which can be performed by multiparametric flow cytometry (MFC) after 1 month, 3-month, 6-month treatment. Relapse free survival (RFS) and overall survival (OS) were compared in patients with different MRD level. Results: The median follow-up was 22 months. All patients was evaluated at 497 MRD level. Patients who reach the good MRD level at 1 month (<0.1% or ≥0.1%), 3-month (negative or positive), 6-month (negative or positive) had a significantly higher probability of estimated RFS (74.5% vs 29.9%; 75.6% vs 29.7%; 74.6% vs 11.6%) and of estimated OS (67.5% vs 30.3%; 71.6% vs 27.8%; 74.0% vs 15.7%). Patients who reach the MRD negative at all 3 times had a significantly higher probability of estimated RFS (80.5% vs 30.5%) and better estimated OS (77.1% vs 29.4%) compared to patients with at least MRD failure in one time (P<0.001). Multivariable analysis showed MRD level at 3-month was an independent prognostic factor for DFS and OS. Conclusion: MRD is an important prognosis factor for Ph-negative B- ALL patients.
Flow Cytometry ; Humans ; Neoplasm, Residual ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Recurrence

Objective:To study the healthcare level (HCL) in China and its influencing factors.Methods:By using the data reported in the China statistical yearbook published by the National Bureau of Statistics and in other public literature, HCL was calculated in terms of the number of population and physicians in the whole country and various provinces. Multiple regression was used to analyze the relationship between HCL and regional population, area, number of administrative divisions and gross domestic product (GDP). Pearson correlation analysis was applied to analyze the relationship between healthcare level and medical radiation frequency. Results:Since 2015, Chinese HCL value was lower than 1 000, but there were two provinces with HCL value greater than 1 000 in 2019. Population and GDP were the influencing factors for the HCL, with correlation coefficients of 0.416 and -0.583, respectively. There was a correlation between HCL and medical exposure frequency of Chinese population( r= -0.620, P=0.028). Conclusions:Chinese HCL value was 542 in 2020, but there has been great differences between various provinces. HCL as an indicator of medical exposure assessment needs further research in China.