Objective To investigate the clinical application value of fibrolarynogoscope in the diagnosis and treatment of otolaryngolgic diseases. Methods Olympus Type-T3 fibrolarynogoscope were used in diagnosis of 3 200 patients. Results 3 200 cases were examined by fibrolarynogoscope, and correct diagnosis was made. 263 cases of foreign bodies in hypopharynx or larynx were moved, 154 cases of nosebleed were treated with MTC-3 microwave therapy apparatus, CX-Ⅲ multifunctional ionization therapy apparatus. Conclusion Fibrolarynogoscope can be widely used in diagnosis and treatment of otolaryngolgic diseases and is an excellent instrument of diagnosis and treatment of otolaryngolgic diseases.

Objective To assess the efficacy and toxicity of topoteean hydllochloride plus carbo-platin(TC)versus etoposide plus carboplatin(CE)in patients for previously untreated small cell lung cancer (SCLC).Methods Sixty-nine patients with previously untreated SCLC,TC group(34 eases)were treated with topotecan 1 mg/m2 from day 1 to day 5 and carboplatin 300 mg/m2on day 1.CE group(35 cases)were treated with etoposide 100 mg/d from day 1 to day 5 and carboplatin 300 mg/m2 on day 1.Treatment was repeated every 3 weeks.The efficacy and toxicity were ev Mumed in patients who received two cvcles of chemotherapy.ResMN The total effective rate Was 76.5%in TC group and 71.4%in CE group(P＞0.05). The progression-free survival interval was 4.1 months in TC group and 2.6 months in CE group(P＜0.05). There was no significant difference in the most common toxieities between two groups(P＞0.05).Conclusion Compared with etoposide plus carboplatin,topotecan plus carboplatin has similar total effective rate,and in- different toxieities,and the longer progression-free survival interval,so it is a safe and effective first-line treatment for SCLC.

Objective To analyze the outcome of intra-artery chemotherapy for T1G3 bladder cancer , and its effectiveness and safety. Methods From June 2003 to May 2014, 39 patients with T1G3 bladder cancer chose intra-artery chemotherapy (Gemcitabine plus cis-platin), and close follow-up was required after 2 cycles of chemotherapy. During the follow-up, transurethral resection of bladder tumor was performed for non-muscle invasive bladder cancer, and cystectomy was performed for muscle invasive tumor. Results Of all patients, 32 were male and 7 were female. The median age was 56 years old (range: 32-82 years), and median follow-up time was 56 months (range: 12-136 months). Nineteen patients were primary bladder cancer, and 20 were recurrent tumor. During the follow-up, 17 patients developed recurrent tumors, including 8 progressed tumors and 3 died from tumor. Two-year and 5-year progressed-free survival were 88% and 74%, and 2-year and 5-year cancer-specific survival were 97% and 89%, respectively. During 5 years′ follow-up, 81% survivor preserved intact bladder, and only 1 patient cancelled chemotherapy for adverse effect. Conclusions Intra-artery chemotherapy (GC regimen) is a choice for T1G3bladder cancer, preventing from disease progression with good tolerance.

Objective: To investigate the medium-term curative effect of transjugular intrahepatic portosystemic shunt (TIPS) through jugular vein with covered Viatorr stent. Methods: Data of 105 consecutive patients with covered Viatorr stent of our hospital was retrospectively analyzed. Follow-up was performed after surgery, and color Doppler was reviewed to evaluate the efficacy of TIPS. Results: Transjugular intrahepatic shunt was successfully established in all patients. The pressure gradients of portal vein before and after operation were 22.33 ± 6.4 mmHg and 9.78 ± 4.9 mmHg, respectively,P< 0.01, and the difference was statistically significant. The follow-up period ranged from 12.7 to 15.6 months, with an average of 13.09 ± 1.4 month. Total bilirubin and coagulation time increased after operation, but there was no significant difference in total bilirubin and coagulation time at 1, 3, 6 and 12 months after operation. The patency rate of shunt was 100%, 99.05%, 99.05% and 99.05% at 1, 3, 6 and 12 months after operation. The incidence of hepatic encephalopathy was 34.2%, 29.5%, 19.1% and 14.3% respectively. The recurrence rate of symptoms was 0%. Conclusion Patients with cirrhotic portal hypertension who underwent TIPS with covered Viatorr stent had a lower rate of restenosis, improved liver function, and a lower incidence of severe hepatic encephalopathy. However, the long-term efficacy needs further observation.

Aim To screen the potential inhibitors of post-transcriptional activity of pro-inflammatory media-tor TNF-α from the lipophilic constituents in Chinese Medicine Salvia miltiorrhiza Bunge ( Danshen) , we es-tablished dual luciferase reporter gene system pGL3-TNF-α3′UTR ( 3′untranslated region ) co-transfected with Renilla control gene. Methods Complementary DNA ( cDNA) template was obtained from human um-bilical vein endothelial cells ( HUVECs ) . The full length DNA of TNF-α 3′-UTR was amplified through PCR, and then connected the luciferase reporter vector pGL3-control after enzyme digestion. pGL3-TNF-α 3′UTR constructs were co-transfected with pSVRenilla into the mononuclear macrophages RAW264. 7 cells. The relative activity of reporter genes was measured by dual luciferase reporter ( DLR ) assay system after the stimulus of lipopolysaccharide ( LPS ) in presence or absence of tanshinones compounds. Results The pGL3-TNF-α3′UTR luciferase reporter gene was suc-cessfully constructed. The cloning DNA fragment and sequence were both consistent with the GENBANK da-tabase. LPS significantly induced the relative reporter activityof RAW264 . 7 cells transfected with pGL3-TNF-α 3′UTR. Among four tanshinones compounds, we found only cryptotanshinone could significantly de-crease LPS-induced relative reporter activity. Conclu-sion The pGL3-TNF-α 3′UTR construct combined with DLR assay system was successfully established, which can be used to discover the agents such as cryp-totanshinone that regulate the post-transcription of TNF-α in treatment of inflammatory and malignant dis-eases.

Objective To evaluate the efficacy of mesalazine combined with compound glutamine in the treatment of radiation related enteritis. Methods Ninety-four patients were randomly divided into the observation group and the treatment group, with 47 cases in each group. Patients in control group were given compound glutamine orally. On the basis of compound glutamine, patients in the observation group was added mesalazine orally. Before and after treatment, all patients were assessed according to acute radiation injury grading (RTOG), and the quality of life (QOL) scale for cancer patients was used to evaluate the improvement of quality of life. Results The total effective rate of the observation group was 95.7％(45/47) , and that of the control group was 78.7％(37/47).The difference was statistically significant (P<0.05). At the end of radiation therapy, patients in the observation group showed significant superiority in quality of life (P<0.05). Conclusions Mesalazine combined with compound glutamine in the treatment of radiation-associated enteritis has advantages and can improve the quality of life.

Objective To evaluate the efficacy and safety of the gemcitabine(GEM) plus S-1 in unresectable cholangiocarcinoma. Methods Forty-nine unresectable cholangiocarcinoma patients from January 2010 to June 2014 were randomly divided into two groups. The experimental group contained 25 patients treated with gemcitabine and S-1 and the control group contained 24 patients treated with gemcitabine and cisplatin. Results The experimental group′s release rate (RR) and disease control rate (DCR) was 36.0% (9/25) and 76.0% (19/25),the control group′s was 25.0(6/24) and 58.3% (14/25), and there were no statistically significant differences (P=0.403 and 0.187). One-year survival rate for the experimental and the control groups were 40.0% (8/25) and 29.2% (7/24), and there was no statistically significant difference (P=0.426). Median overall survival (OS) in the experimental and control groups was 13.0 and 12.3 months, and there was no statistically significant difference (χ2=0.273, P=0.602). The rate ofⅠ～Ⅱgrade of oral mucositis was more higher than that in the control group [25.0%(6/24) vs. 4.0% (1/25), P=0.036 ]. Conclusions Combination of GEM and S-1 provides a better OS and response rate, and is safer.

Epidemiological survey shows that the prevalence, incidence rate and symptoms of mental disorders are affected by sex. A large number of studies have shown that men and women respond differently to psychotropic drugs in clinical application. Moreover, some studies have shown that there are sex specific psychotropic drug use patterns in patients with depression. This paper summarizes the sex differences in pharmacokinetics of psychotropic drugs caused by physiological differences between men and women, and collates the current pharmacodynamic studies of mainstream clinical psychotropic drugs, with special attention to the effect of sex hormones on the therapeutic response of psychotropic drugs. This paper discusses the specific role and necessity of therapeutic drug monitoring in dealing with clinical sex differences in psychotropic drugs, hoping to provide reference for individual rational drug use.

Objective: To explore the clinical outcome of advanced testicular nonseminomatous germ cell cancer patients undergoing post chemotherapy retroperitoneal lymph node dissection (PC-RPLND), and to analyze the relevant prognostic factors of lymph node pathological. Methods: A total of 43 consecutive testicular nonseminomatous germ cell cancer patients underwent PC-RPLND between March 2001 and December 2014 in Department of Urology at Sun Yat-sen University Cancer Center were retrospectively reviewed. The average age of the patients was (29.0±11.5) years (ranging from 12 to 58 years). Before PC-RPLND, 22 patients were classified as phase Ⅱ, while 21 were phase Ⅲ. Primary tumor histology revealed seminomatous elements in 19 cases, embryonal cell carcinoma in 22 cases, yolk sac tumor in 13 cases, chorionic carcinoma in 3 cases, mature teratomatous elements in 11 and immature teratomatous elements in 2 cases. Patients were treated with cisplatin-based chemotherapy after orchectomy and then underwent surgical resection of retroperitoneal lymph nodes.After PC-RPLND, all patients underwent a periodic review including the blood routine, biochemistry routine and computed tomography or ultrasonograph of the chest, the abdomen and the pelvis. The association of pathological data with patient′s clinic features and the correlations between molecular features detected with each other were assessed by the t test, χ² and Fisher′s exact test. Multivariate logistic regression were used to assess prognostic factors. Results: The median operative time was 278 minutes (ranging from 50 to 715 minutes). Median blood loss was 425 ml (ranging from 50 to 5 000 ml). Eight patients received blood transfusion intra-operatively, 2 patients underwent adjunctive surgical procedures, 4 patients developed ileus and 4 had an ascites chylosus following PC-RPLND, 1 patient had a postoperative hyperthermia and retrograde ejaculation was present in 10 patients. The transverse diameter of the residual tumor in patients ranged from 0.8 to 18.2 cm. Necrosis, teratoma and viable germ cell tumors were found in 15, 17 and 11 of all patients. The median follow-up time was 46 months (ranging from 6 to 169 months). There were 39 patients had no tumor recurrence, 7 patients were found recurrence after PC-RPLND, 5 died of malignant germ cell tumor. The normal serum lactate dehydrogenase (LDH) level before chemotherapy (HR=25.811, 95%CI: 0.678 to 982.624, P=0.017) and relative changes more than 50% in retroperitoneal lymph node size (HR=0.016, 95%CI: 0 to 0.698, P=0.032) were statistically significant prognostic factors of the presence of necrosis. Conclusions Since most residual masses are not sensitive to chemotherapy, PC-RPLND is still an essential part of the treatment of metastatic testicular nonseminomatous germ cell cancer. Patients with the normal serum LDH level before chemotherapy and a shrinkage of 50% or more in retroperitoneal mass have a considerably chance of having necrosis in the retroperitoneum resection. This may help to refine the selection of candidates for PC-RPLND.

Objective:To evaluate right atrial (RA) volume and function in patients with hepatitis B cirrhosis by four-dimensional automatic quantitation analysis technique, and to explore its correlation with liver function grading.Methods:Ninety patients with hepatitis B cirrhosis who were clinically confirmed in Henan Provincial People′s Hospital from December 2020 to July 2021 were randomly enrolled as the research subjects. According to Child-Pugh liver function score criteria, the patients were divided into three groups: Child-Pugh A group ( n=31), Child-Pugh B group ( n=31), Child-Pugh C group ( n=28). Another 30 healthy volunteers with gender and age matched at the same period were selected as the control group. The RA maximum volume (RAVmax), RA minimum volume (RAVmin), RA presystolic volume (RAVpreA), RA maximum volume index (RAVImax), RA emptying volume (RAEV), RA ejection fraction (RAEF), RA reservoir longitudinal and circumferential strains (RASr, RASr-c), RA conduit longitudinal and circumferential strains (RAScd, RAScd-c), RA contraction longitudinal and circumferential strains (RASct, RASct-c) were obtained by four-dimensional automatic quantitation analysis technique. Spearman correlation analysis was used to explore the correlation between the volume and strain parameters of right atrium and liver function grading, and the independent correlation factors of RASr-c were analyzed by univariate and multivariate linear regression analyses. Results:Compared with the control group, Child-Pugh A and Child-Pugh B groups, RAVmax, RAVmin, RAVpreA, RAVImax, and RAEV were all increased in Child-Pugh C group (all P<0.05). Compared with control group, the absolute values of RASr, RASct, RASr-c and RASct-c were increased, and the absolute values of RAScd and RAScd-c were decreased in Child-Pugh A group (all P<0.05). Compared with control group, Child-Pugh A and Child-Pugh B groups, the absolute values of RASr, RAScd, RASct, RASr-c, RAScd-c and RASct-c were decreased in the Child-Pugh C group (all P<0.05). Correlation analysis showed that the volume and strain parameters of the right atrium were correlated with liver function grading. RASr-c was independently correlated with E/e, ALB and BNP(β=-0.543, 0.521, and -0.562 respectively, all P<0.05). Conclusions:During the compensatory stage in patients with hepatitis B cirrhosis, the RA functions of reservoir and contractile were increased, but the function of conduit was decreased. With the aggravation of liver cirrhosis, the RA functions of reservoir, conduit and contractile were all decreased. The four-dimensional volume and strain parameters of the right atrium were correlated with Child-Pugh liver function grading, and RASr-c was independently correlated with E/e, ALB and BNP.