Objective To investigate the curative effect and safety of transcatheter arterial chemoembo -lization (TACE) containing raltitrexed scheme for primary hepatocellular carcinoma (PHCC).Methods From May 2013 to June 2014,a total of 90 patients with inoperable PHCC were treated with TACE containing raltitrexed scheme.The short-term effect,long-term effect and adverse reactions were analyzed.Results Of the 90 patients,complete response was obtained in 23,partial response in 36,stable disease in 24 and progressive disease in 7,the effective rate was 65.6％.The one-year survival rate was 72.2％,the median survival time was 15.9 months,and the progression free survival was 9.1 months.Single factor analysis showed that the statistically significant differences in survival rate existed among the patients with different BCLC staging,combination therapy,lipiodol deposit pattern and vascular tumor thrombus (P＜0.05).Multivariate analysis of Cox model indicated that BCLC staging (x2=9.83,P=0.002) and combined therapy (x2=6.40,P=0.011) were independent prognostic factors.The main adverse reactions were fever,pain,vomiting and bone marrow suppression.Grade Ⅲ-Ⅳ adverse reactions were rare and no treatment-related death occurred.Conclusion For the treatment of inoperable PHCC,TACE containing raltitrexed scheme is effective and safe,and this therapy can be well tolerated by patients.

Objectives To compare the clinical features between rhinovirus and respiratory syncytial virus infection in lower respiratory tract in children. Methods From December 2012 to May 2013, direct immunofluorescence assay was per-formed to test RSV in 1 037 nasal aspirate specimens with LRTIs. RT-PCR method was used to test HRV RNA. The medical re-cords of patients with a positive test of HRV or RSV were reviewed and compared. Results The isolating rate for HRV and RSV was 8.78%(91/1 037) and 17.16%(178/1 037) respectively. The frequency of co-infection of HRV with other virus was 18.68%, higher than that of RSV (7.30%,χ2=7.867, P=0.005). The age distribution had significant difference between children infected with HRV and RSV (Z=5.40, P<0.001). 78.38% patients with HRV infection were younger than 3 years old, and 83.03%patients with RSV infection were younger than 1 year old. Dyspnea, hyoxemia and wheezing were more common in pa-tients with RSV infection. Admission occurred much later in the course of the HRV infection (P<0.01). Leukocytosis, eosinophi-lia, and an elevated total serum IgE were more common in patients with HRV infection (P<0.05). Conclusions HRV is one of the important causes of LRTIs in Suzhou. The susceptible population, clinical presentation and laboratory results of HRV infec-tions are different from that of RSV infections.

Objective:To investigate the values of ultrasound elasticity(UE)imaging and color Doppler flow energy(CDFI)in differential diagnosis for triple negative breast cancer(TNBC)and fibroadenoma.Methods:A total of 50 TNBC patients who admitted to People's Hospital of Wanning from January 2021 to January 2022 and were confirmed by surgical pathology were selected,and they were divided into TNBC group.On the other hand,a total of 50 patients with fibroadenoma who were confirmed by surgical pathology during the same period were selected and they were divided into fibroadenoma group.All patients did not undergo any clinical intervention before ultrasound examination.UE and CDFI were used respectively to evaluate the degrees of softness and hardness of the tissues,the color blood flow and elasticity scores of lesions.The pathological result was used as the gold standard to analyze respectively the diagnostic efficacies of UE and CDFI for TNBC and fibroadenoma.Results:According to the characteristics of ultrasound imaging,the TNBC group mostly showed burr sign on lesion edge,the attenuation and hyperechoic halo of posterior echo,and existing axillary lymph node metastasis.The fibroadenoma group mostly showed clear boundaries of lesion area,regular lesion morphology,non-microcalcification.The diagnostic sensitivity,specificity and accuracy of UE detection were respectively 90.91%,82.14%and 86.00%,while these indicators of CDFI were respectively 73.08%,75.00%and 74.00%.In addition,the sensitivity,specificity and accuracy of the combined detection of them were respectively 94.23%,95.83%and 96.00%.The detection efficiency of the combined detection was higher than that of each single detection.Conclusion:UE has higher sensitivity in the differential diagnosis of TNBC and fibroadenoma,but it's specificity is not high.The combined detection of UE and CDFI can improve the specificity and accuracy of differential diagnosis.

Objective To discuss the effects of mutual management model on the recovery of multi-burn family members. Methods The multi-burn family members who were hospitalized the 180th Hospital of PLA from February 2010 to October 2014 were chosen as study objects, and 68 patients who were discharged to the hospital from February 2010 to March 2012 were chosen as the control group, while 70 patients who were discharged to the hospital from April 2012 to October 2014 were chosen as the observation group. The two groups of patients were hospitalized for the same treatment, and the patients in control group received general guidance for rehabilitation, while the patients in observation group were administered with the application of mutual management model being discharged, and the members of the family monitored, helped and encouraged each other; they received follow-up survey at 1 month, 6 months, 1 year and 3 years after being discharged, and the effects of mutual management on improving the quality of life and returning to the job (work and study) were analyzed. Results The quality of life after 6 months discharged in two groups had statistical significance (F=424.679,P<0.01), the quality of life in observation group were higher than that of control group in body, psychology and social function, and status of material life (t=5.115、4.088、4.314、4.760;P<0.01). The length of returning to job or school was shorter than that of control group (χ2=8.101,P<0.05). Conclusions The mutual management model could effectively utilize the resources, and the patients managed with each other, took care each other and encourage each other, so as to improve the quality of life.

Objective: To study serum zinc level in pregnancy and umbilical cord blood and their association with newborn birth weight. Methods: Pregnant women accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. The follow up was conducted during their first, second and third trimesters of pregnancy and the self-designed questionnaire was used to collect information of social and demographic characteristics. Blood samples in the first, second pregnancy period and umbilical cord blood samples were collected and serum concentrations of zinc were assayed. 3 239 mother-infant entered the final analysis. We divided serum zinc level into low (<P₂₅), medium (P₂₅-P₇₅) and high (>P₇₅) groups according to their exposure concentrations at each trimesters. Non-conditional multivariate logistic regression model was conducted to evaluate the association between serum zinc level in first, second trimesters of pregnancy and umbilical cord blood with small for gestational age (SGA) and large for gestational age (LGA). Results: Serum zinc level in P₅₀ (P₂₅-P₇₅) during the first, second trimesters and cord blood were 1 016.18 (907.09-1 145.60), 813.36 (732.47-897.89) and 903.44 (808.71-1 015.64) μg/L, respectively. The prevalence of zinc deficiency during the first, second trimesters and cord blood were 1.5% (44/2 957), 15.9% (492/3 087) and 6.5% (176/2 707), respectively. The prevalence of total SGA and LGA were 9.7% (313/3 239) and 16.5% (536/3 239), respectively. Compared to high-level serum zinc group, the risk of SGA (OR (95%CI) in low-level serum zinc group during first trimesters was 1.51 (1.05-2.19)). Serum zinc level among second pregnancy period and umbilical cord blood had no statistically significant effect on SGA and LGA (both P values >0.05). Conclusion Zinc nutritional status of pregnant women in Ma'anshan city was at a good level. The low serum zinc level in first trimester increased the risk of SGA.

Zinc oxide nanoparticles(ZnO NPs)have been gradually introduced into people's lives due to their excellent properties.In daily contact,ZnO NPs can enter the human body in a variety of ways and accumulate in tissues and organs.Inhalation is an important means by which ZnO NPs enter the human body and deposit in lungs.Studies have shown that exposure of lungs to ZnO NPs will cause a range of negative effects.The mechanism of pulmonary toxicity induced by ZnO NPs is related to Zn2+release,oxidative stress,DNA damage,autophagy,inflammation and pulmonary surfactant dysfunction.This paper reviews the pulmonary toxicity and mechanisms of ZnO NPs,and summarizes the prevention and treatment strategies,which provides scientific basis for safer use of nanomaterials,and potential intervention strategies for the prevention and treatment of nanotoxicity.

Objective: To analyze the association between maternal bisphenol A exposure during early pregnancy and sleep problems among preschool children. Methods: Research subjects were from one of the sub-cohorts(Ma'anshan Cohort) of the China-Anhui Birth Cohort Study (C-ABCS) in Ma'anshan city. The basic situation of pregnant women and sleep information of preschool children were investigated. We selected preschool children whose mother's maternal serum bisphenol A concentrations of the first trimester had been already detected between December 2012 to Januray 2014. 1 259 pairs of mothers and children were included. The concentrations of bisphenol A exposure during early pregnancy were divided into low, medium and high exposure groups according to 25^th percentile (P₂₅) and 75^th percentile (P₇₅) levels. Multivariate multinomial logistic regression model was used to analyze the association between maternal bisphenol A exposure during early pregnancy and sleep-related problems in preschool children. Results: The P₅₀ (P₂₅-P₇₅) of serum bisphenol A exposure level during early pregnancy was 0.231 (0.106-0.512) ng/ml. The sleep-related problems scores of 1 259 preschool children were (16.43±3.82) points. The occasional sleep-related problems were detected about 47.8% (602 cases) and frequent sleep-related problems were detected about 18.3% (230 cases). After the adjustment of the confounding factors such as children's gender, age, BMI, sleep position (lying down, sleeping on one's back), the length of time to sleep and the length of sleep at night, in comparison with bisphenol A low exposure group, the OR (95%CI) value of preschool children with occasional sleep-related problems in maternal bisphenol A high exposure group during early pregnancy was 1.44 (1.01-2.06). After the gender stratification, the results showed that in comparison with bisphenol A low exposure group, the OR (95%CI) value of preschool girls with occasional sleep-related problems in maternal bisphenol A medium and high exposure group during early pregnancy were 1.61 (1.05-2.46) and 2.40 (1.42-4.04), respectively. The OR (95%CI) value of preschool girls with frequent sleep-related problems in maternal bisphenol A high exposure group during early pregnancy was 2.64 (1.34-5.17). However, in boys, there was no statistically significant association between maternal bisphenol A exposure during early pregnancy and sleep-related problems (P>0.05). Conclusion Maternal bisphenol A exposure during early pregnancy might be related to sleep-related problems in preschool children.

Objective:To explore the association between maternal bisphenol A (BPA) exposure during pregnancy and neurobehavioral development in infant.Methods:Participants were from the Ma’anshan Birth Cohort, which was established from October 2008 to October 2010 based on four municipal medical and health institutions in Ma'anshan. High-performance liquid chromatography-tandem mass spectrometry was applied for the determination of serum BPA concentration in 1 783 pregnant women sampled at their first filing, and during 2.97 to 28.1 months age of the infants. Neurobehavioral development were assessed by 0-6-year-old pediatric examination table of neuropsychological development. Generalized linear model was used to analyze the association between serum BPA levels during pregnancy and infants’ neurobehavioral development.Results:A total of 931 mother-child pairs had complete data on serum BPA detection during pregnancy and assessment of infants’ neurobehavioral development status. The age of pregnant women at their first filing was (26.67±3.45) years old, and the M ( P25, P75) of serum BPA concentration (ng/ml) was 0.23 (0.11, 0.52), with a detection rate of 84.1% (783/931). The age of infants was (13.18±5.46) months, and 53.5% (498) were boys. The developmental quotient scores of large motor, fine motor, adaptive ability, language ability and social behaviors of infants were (97.88±16.32), (97.16±15.35), (99.64±15.47), (95.3±16.04) and (98.95±14.76) points, respectively. Generalized linear model showed that after adjusting for factors such as delivery mode, feeding mode, family per capita monthly income, preterm delivery, gender, maternal age, residence, pre-pregnancy body mass index and residence time, serum BPA level in pregnancy was negatively associated with infant’s development of social behavior [β (95% CI):-2.42 (-4.71, -0.12)]. The post-stratification analysis by infant age revealed that the serum BPA level in pregnancy was only negatively associated with the development of language and social behavior developmental quotient scores in infants between the ages of 12 and 18 months, with β (95% CI) about -6.66 (-13.06, -0.25) and -7.401 (-12.97, -1.83), respectively. Conclusion:BPA exposure during pregnancy affects language and social behavior development in infants, and the detection window is between 12 and 18 months old of the infant.

Objective:To explore the association between maternal bisphenol A (BPA) exposure during pregnancy and neurobehavioral development in infant.Methods:Participants were from the Ma’anshan Birth Cohort, which was established from October 2008 to October 2010 based on four municipal medical and health institutions in Ma'anshan. High-performance liquid chromatography-tandem mass spectrometry was applied for the determination of serum BPA concentration in 1 783 pregnant women sampled at their first filing, and during 2.97 to 28.1 months age of the infants. Neurobehavioral development were assessed by 0-6-year-old pediatric examination table of neuropsychological development. Generalized linear model was used to analyze the association between serum BPA levels during pregnancy and infants’ neurobehavioral development.Results:A total of 931 mother-child pairs had complete data on serum BPA detection during pregnancy and assessment of infants’ neurobehavioral development status. The age of pregnant women at their first filing was (26.67±3.45) years old, and the M ( P25, P75) of serum BPA concentration (ng/ml) was 0.23 (0.11, 0.52), with a detection rate of 84.1% (783/931). The age of infants was (13.18±5.46) months, and 53.5% (498) were boys. The developmental quotient scores of large motor, fine motor, adaptive ability, language ability and social behaviors of infants were (97.88±16.32), (97.16±15.35), (99.64±15.47), (95.3±16.04) and (98.95±14.76) points, respectively. Generalized linear model showed that after adjusting for factors such as delivery mode, feeding mode, family per capita monthly income, preterm delivery, gender, maternal age, residence, pre-pregnancy body mass index and residence time, serum BPA level in pregnancy was negatively associated with infant’s development of social behavior [β (95% CI):-2.42 (-4.71, -0.12)]. The post-stratification analysis by infant age revealed that the serum BPA level in pregnancy was only negatively associated with the development of language and social behavior developmental quotient scores in infants between the ages of 12 and 18 months, with β (95% CI) about -6.66 (-13.06, -0.25) and -7.401 (-12.97, -1.83), respectively. Conclusion:BPA exposure during pregnancy affects language and social behavior development in infants, and the detection window is between 12 and 18 months old of the infant.