OBJECTIVE:To manufacture non-PVC multilayer extrusion film infusion bag and establish its quality standard METHODS:Polypropylene(PP),Polyethylene(PE) and Polyamide(PA) were mixed in proportion and extruded into film Infusion bag was prepared with the film Accroding to the demend of bulk infusion,its quality standard was established RESULTS:The infusion bag was good in quality,simple in preparation technic with no need of expensive facility CONCLUSI_ON:Non-PVC multilayer extrusion film infusion bag is worth further investigating

Objective To study the influences of the length of sexual abstinence on sperm parameters and seminal plasma biochemical indicator.Methods Sperm concentration and motility were detected by computer assisted sperm analysis(CASA).The sperm morphology was analyzed using semiautomatic sperm morphology analyzer.Seminal plasma fructose concentration,neutral a-glycosidase,zinc,and acid phosphates concentration were measured by spectrophotometer.Improved DTNB was conducted for detection of the content of seminal plasma novain.Prostatespecific antigen(PSA)was measured with commercial kit.Three groups were defined according to the days of sexual abstinence:G1(1-3 days),G2(4-5 days)and G3(＞6 days).Results Sperm concentration of G2 was significantly higher than that of G1(P＜0.01),and of G3 than that of G1 and G2(P＜0.01).Sperm motility and per centage of morphologically normal sperm of G3 were significantly lower than that of G1(P＜0.01).Seminal plasma fructose concentration of G3 was significantly lower than that of G1 and G2(P＜0.01,P＜0.05).Seminal plasma neutral a-glycosidase,carnutine,zinc concentration of G3 was significantly higher than that of G1 and G2(P＜0.01,P＜0.05).Conclusion The length of sexual abstinence can influence sperm parameters and seminal plasma biochemical indicator.

Objective To evaluate the precision of image guided radiotherapy (IGRT) for vertebra metastasis.Methods Cone-beam computed tomography (CBCT, ELEKTA SynergyTM) scanning was performed to 15 patients with vertebra metastasis treated with three dimensional conformal radiation therapy (3DCRT) or intensity modulated radiation therapy (IMRT).CBCT images were then compared with corresponding planning images to calculate the position errors.The isocenter was adjusted based on the errors calculated , CBCT scanning was re - performed , and the new - errors were then calculated .Results Compared to the firstly collected CBCT images, the average errors of 4 cases of cervical bone metastases in x (left-right), y (cervical-caudal), and z (anterior-posterior) directions were 1.8 mm, 0 mm and 3.6 mm respectively.After adjusting the isocenter, the new-errors were reduced to 0.1 mm, 0.4 mm and 0.3 mm.For 11 cases of thoracic and lumbar bone metastases, the average errors in x, y, and z directions were 1.9 mm, 0.1 mm, and -2.1 mm, respectively.While the new-errors were reduced to 0.9 mm, 0.5 mm and -0.3 mm.Conclusions IGRT can improve the precision of radiotherapy for vertebra metastasis to less than 2 mm, which provides a possibility of dose escalation in GTV while reduce the dose in the spinal cord.

Objective To investigate the effects of a chitosan product on scarring and adhesion after never injury in laminectomy in rats. Methods 48 male Sprague-Dawley rats were divided into group A and group B, and carried laminectomy of L4-5, and injured the right spinal nerve roots. The normal saline was smeared on the operation field in the group A, while the chitosan product was smeared in the group B. The adhesion was assessed with Rydell score 1 (groups A1/B1), 2 (groups A2/B2) and 4 (groups A3/B3) weeks after operation, while the spinal nerves were observed with HE staining and Masson staining, and the adhesion was assessed with Nussbaum score. The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were measured. Results The Rydell scores of adhesion was I grade in group A1, II grade in A2 and III grade in A3, while was 0 grade in B1, 0 grade in B2 and II grade in B3. The scar and adhesion contact more loosely in the group B than in the group A, and the Nussbaum score was less in the group B than in the group A at the same time (P<0.05). The complete blood count and the series of blood chemistries and enzymes for liver and kidney functioning were in normal. Conclusion This chitosan product can prevent the formation of epidural scar and adhesion around the spinal and the nerve roots after laminectomy, with little toxicity and side effects.

Objective To observe the clinical effect of a modified version of constraint-induced movement therapy(MCIMT)on motor recovery in the upper extremities of stroke patients. Methods Twenty-seven stroke patients were randomly divided into a treatment group(n=14)and a routine group(n=13).The Bobath approach and functional arm exercise were administered to the patients in the routine group(2 h/d,5 times a week)for ten weeks.The MCIMT administered to the treatment group involved restriction of the functional arm by a sling during 90%of waking time and during training(by shaping)of the affected extremity(1 hour per day,three times a week)in addition to activities of daily living exercise for at least 2 hours every day.The main outcome measures were the ten items of the simplified test for evaluating hand function(STEF)and Wolf's Motor Function Test(WMFT). Results No significant difference was observed between the 2 groups with regard to WMFT and STEF scores before treatment.After treatment,both groups had improved their WMFT and STEF scores significantly,but there was a significant difference between the treatment and the control groups with regard to WMFT scores and 7 items of the STEF test. Conclusion Modified constraint-induced movement therapy is effective not only for promoting motor recovery of the upper extremity,but also for improving the flexibility and velocity of movement instroke patients.

Objective To analyze the efficacy and safety of hypofractionated stereotactic radiotherapy ( FSRT ) combined with temozolomide ( TMZ ) for large brain metastases ( BMs ) in a prospective phaseⅡclinical trial.Methods From 2010 to 2015, a total of 33 patients were enrolled as subjects.The median Karnofsky Performance Status scores before and after treatment were 70 and 80, respectively.The major primary tumor was non-small cell lung cancer (57.6%).The brain metastasis had a diameter of≥3 cm or a volume of ≥6 cm3 .The radiation dose was 52 Gy in 13 fractions or 52.2 Gy in 15 fractions.Patients received TMZ at a dose of 75 mg/m2 per day concurrently.The radiotherapy was followed by 6 cycles of adjuvant treatment with TMZ (150 mg/m2, days 1-5, 28 days per cycle).Patients were reexamined by magnetic resonance imaging ( MRI) during the treatment.The radiation field would be shrunk if the gross target volume ( GTV) was reduced by≥20%.The treatment outcomes were evaluated by MRI at 2-3 months after treatment.Results The total numbers of tumors and GTVs were 95 and 38, respectively. Twenty-four (63%) out of the 38 GTVs had a volume larger than 10 cm3 and the median GTV was 15.3 cm3 (5.7-142.8 cm3).Twenty-two (67%) out of the 33 patients achieved field shrinking during the treatment, and the median reduction rate of GTV was 44%( 21%-88%) .The median total dose was 59.5 Gy, and 100%and 21.2%of patients completed the concurrent and adjuvant treatment with TMZ, respectively.In all patients, the overall response rate was 97.0%;the 1-year local control, intracranial progression-free
survival, and overall survival rates were 97%, 70%, and 62%, respectively;the median survival time was 15.3 months.The main adverse reactions were grade 1-2 nausea and vomiting.One patient got grade 3 liver function impairment.Conclusions FSRT combined with TMZ is a safe and effective approach for treating large BMs.More than 50%of patients can achieve field shrinking to shorten treatment duration and reduce toxicity.Clinical Trial Registry ClinicalTrials.gov,registration number:NCT02654106.

Objective:To observe any relationship between corticospinal tract integrity and the upper limb motor function of stroke survivors treated with repetitive transcranial magnetic stimulation (rTMS).Methods:Bilateral corticospinal tracts (CSTs) were reconstructed in ischemic or hemorrhagic stroke survivors with upper limb motor dysfunction using diffusion tensor imaging (DTI). Thirty patients with good CST integrity (rFA>0.5) and 30 with rFA≤0.5 were further divided into a high frequency rTMS group (HF, n=10), a low frequency group (LF, n=10), and a control group ( n=10). All groups were given routine rehabilitation, while the high and low frequency groups were additionally provided with 5Hz and 1Hz rTMS respectively applied over the M1 area of the contralesional hemisphere. Before and after 3 weeks of treatment, all of the subjects were evaluated using the Fugl-Meyer upper extremity scale (F-M UE), the Wolf Motor Function Test (WMFT) and the Modified Barthel Index (MBI). Results:For the high CST integrity group, significant improvement was observed in the average scores of all measurements, with the average FMA-UE, WMFT and MBI scores of the LF group [(38.10±5.71), (43.20±5.32) and (78.00±11.35)] significantly better than those of the other 2 groups. Among the low CST integrity group, the HF subgroup showed greater improvement than the other 2 on average.Conclusions:For patients with good CST integrity, LF-rTMS over the contralesional cortex is superior to HF-rTMS in promoting upper limb motor function, while for patients with low CST integrity HF-rTMS over the contralesional cortex has a better effect than LF-rTMS or sham stimulation in terms of improving upper limb motor function after a stroke.

Objective:To investigate the efficacy of Mirabegron plus microecologics for the treatment of overactive bladder(OAB)in elderly women.Methods:In this prospective study, 104 patients diagnosed with OAB in the urology department of our hospital between February 2020 and December 2021 were recruited.The participants were randomly divided into two groups, with 52 in each.Group I was treated with Mirabegron alone(50 mg, qd)and Group Ⅱ was treated with Mirabegron(50 mg, qd)plus probiotics(3.5 g, bid)for 12 weeks.The efficacy was evaluated based on results before and after treatment, using measurements including the daily frequencies of urinary urgency, nocturia, daytime urination, urge incontinence and bladder capacity.The overactive bladder symptom score(OABSS), the quality-of-life score, and the number of lower urinary tract infections during treatment were also collected.Results at different treatment stages(week 4 and week 12)were compared within each group and between the two groups by Dunnett's test.Results:The symptoms of OAB in both groups were significantly improved after 12 weeks' treatment.In the group(Group Ⅱ)receiving the combination of two drugs, results from four measurements, the frequency of 24-hour urination(6.6 ± 0.7 vs.7.1 ± 1.2), the frequency of 24-hour urinary urgency(0.6 ± 0.6 vs.1.1 ± 0.7), the frequency of daily nocturia(0.8 ± 0.7 vs.1.3 ± 0.6)and the quality-of-life score(1.2 ± 0.7 vs.2.3 ± 0.8), were all significantly more favorable than in the group(Group I)treated with Mirabegron( P<0.05).The incidence of lower urinary tract infections and constipation was significantly reduced in the group with drug combination treatment. Conclusions:The efficacy of Mirabegron combined with microecologics for the treatment of OAB is better than that of Mirabegron alone, and the incidence of adverse events such as infections and constipation is also lower.

Objective To retrospectively analyze and compare the clinical efficacy and safety between fractionated stereotactic radiotherapy (FSRT) combined with and without temozolomide in the treatment of large brain metastases.Methods Between 2009 and 2017,84 patients with large brain metastases (tumor size ≥ 6 cm3) were recruited and assigned into the CRT group (concurrent TMZ and FSRT,n=42) and RT group (FSRT alone,n=42).The radiation dose was 52.0 Gy in 13 fractions or 52.5 Gy in 15 fractions.Patients were reexamined by magnetic resonance imaging (MRI) during treatment.The radiation field would be shrunk if the gross target volume (GTV) was reduced.The clinical efficacy was evaluated at postoperative 2 to 3 months.The primary end-point event was local recurrence-free survival (LRFS) and the secondary end-point events included intracranial progression-free survival (IPFS),progression-free survival (PFS),overall survival (OS),brain metastasis-specific survival (BMSS) and adverse events.The survival rates were assessed with Kaplan-Meier method and log-rank test and monovariate analysis.Results The median GTV in the CRT and RT groups was 16.9 cm3 and 15.7 cm3.During the treatment,75％ of the lesions in the CRT group were reduced compared with 34％ in the RT group (P=0.000).The local control (LC) rate in the CRT and RT groups was 100％ and 98％.The median follow-up time was 16.1 months (range,2.1-105.7 months).In the CRT group,the LRFS (P=0.040),IPFS (P=0.022),PFS (P=0.045),OS (P=0.013) and BMSS (P=0.006) were significantly better than those in the RT group,respectively.In the CRT group,the incidence of grade Ⅰ-Ⅱ gastrointestinal adverse events was 33％,significantly higher compared with 26％ in the RT group (P=0.006).No grade Ⅳ-Ⅴ adverse events occurred in both groups.Conclusion Combined application of temozolomide and FSRT can further enhance the LC and survival rates and do not increase the risk of severe adverse events in patients diagnosed with large brain metastases.

OBJECTIVE To evaluate the budget impact on medical insurance fund upon the treatment of pulmonary arterial hypertension（PAH）included in the outpatient special and chronic disease management policy （hereinafter refer to as the Policy ）， so as to provide reference for medical insurance reimbursement decision-making. METHODS Based on the perspective of medical insurance payer ，a budget impact model with 10 million people was built to calculate the budget impact on the medical insurance fund in the next three years （2021-2023）after PAH treatment included in the Policy. The measured cost mainly included the cost of medicine，outpatient registration ，examinations，hospitalizations，and death events. RESULTS A total of 34-36 patients with PAH per year were expected to use targeted therapy during 2021-2023. For cities with outpatient costs not covered by the pooling fund of basic medical insurance ，upon the treatment of PAH included the Policy ，the annual expenditure of the medical insurance fund increased by about 40 000 yuan，i.e. an increase of about 1 000 yuan per patient. For cities with outpatient costs covered by the pooling fund ，the annual expenditure of the medical insurance fund increased by about 80 000 yuan，which was equal to 2 000 yuan increase per patient. The increment of above cost decreased year by year. CONCLUSIONS The incremental expenditure of the medical insurance fund is controllable after the treatment of PAH included the Policy ；with the implementation of the Policy ，the incremental expenditure of the medical insurance fund will be reduced year by year.