Objective To explore correlation between gene polymorphism of TNF-alpha and thyroid associated ophtalmopa thy (TAO) in Zhuang ethnic population.Methods DNA and serum samples were collected in patients with TAO in Han/Zhuang population.ELISA was applied to detect level of TNF-alpha in serum and PCR was applied to detect polymorphism of TNF-alpha gene 863C_A.Results The levels of TNF-alpha in patients with TAO increased significantly compared with control group (P ＜ 0.05),and more significantly in Zhuang population compared with Han population (P ＜ 0.05) ;gene frequency of CA was significantly higher in patients with TAO in Zhuang population than that in Han population (P ＜ 0.05),while gene frequency of AA was significantly lower (x2 =0.770,2.145,all P ＜ 0.05).Conclusion Serum level of TNF-alpha increases during occurrence of TAO,and the differences of expression level between different nationalities are due to gene polymorphism of TNF-alpha.

Objective To investigate potential association of XRCC1-Arg399Gln polymorphism with hyroid-tassociated ophthalmopathy(TAO).Methods XRCC1-Arg399Gln polymorphism was identified by PCR-RFLP in 182 patients with TAO and 182 healthy subjects.Results The significant difference of the allelic frequency distribution was found between TAO and control group(P

Objective To investigate the effects of iodine on the pathogenesis of Graves′ disease (GD). Methods The thyroid epithelium cells (TEC) from GD patients and para adenoma normal tissue from thyroid adenoma patients wereculturedrespectivelywithdifferentNaⅠconcentrations from 0 to 1 mg/L. The HLA DR expression of TEC was detected with Western blot. Meanwhile, the morphological change of TEC was observed after treatment of NaⅠ by scanning electronmicroscope (SEM). Results (1) When the concentration of NaⅠ in culture medium was over 100 ?g/L, the amount of HLA DR expression of TEC increased in GD group (P

AIM: To elucidate the relationship of inflammation, coagulation and cholesterol gallstone formation. METHODS: Hamsters were divided into four groups: control group (feeding normal diet), lithogenic diet (LD) 2 weeks group, LD 6 weeks group and LD+aspirin 6 weeks group. Gallstone incidence, antithrombin antigen (AT-Ⅲ:Ag), antithrombin activity (AT-Ⅲ:Ac), thrombin (F-Ⅱa:Ac), plasminogen activator inhibitor activity (PAI:Ac), plasmin activity (Plm:Ac), D-dimer:Ag and C-reactive protein (CRP) in gallbladder bile were observed as read-out parameters. RESULTS: The incidence of gallstones in control group, LD 2 weeks group, LD 6 weeks group and LD+aspirin group were 0%, 20%, 73% and 25%, respectively. AT-Ⅲ:Ag, F-Ⅱa:Ac, D-dimer and CRP in LD 2 weeks group and LD 6 weeks group were significantly higher than those in the control group (P

AIM: To elucidate the mechanism of fibrin in cholesterol gallstone disease. METHODS: Hemostatic indices were systemically examined in the gallbladder bile obtained from 26 patients with gallstones and 17 without gallstones. RESULTS: Significant increases were found in tissue factor (TF) concentration( P

Objective To explore the application effect of chemotherapy management table in breast cancer case management mode. Methods By using the convenient sampling method,breast cancer patients who recruited the breast cancer case management were selected from January 2016 to December 2017 in the Sun Yat-Sen University Cancer Center as the research objects. 182 patients who were admitted from January to December 2016 were included in the control group;183 patients who were admitted from January to December 2017 were included in the intervention group. The control group carried out the breast cancer case management mode,and the intervention group used the chemotherapy management plan table to nurse the patients. The intervention effect of the two groups was compared. Results In the control group,98.35％(179/182)patients completed chemotherapy on time,and in the intervention group,99.45％(182/183)patients completed chemotherapy on time. There was no significant difference in the compliance between the two groups(χ2=0.258,P> 0.05). In the control group,84.06％(153/182)patients completed the auxiliary examination on time,and in the intervention group,98.36％(180/183) patients completed the auxiliary examination on time. There was a significant difference between the two groups (χ2=21.559,P<0.01). The standard accuracy rate of the treatment of abnormal index in the control group was 75.82％(138/182),and that in the intervention group was 92.90％(170/183). There was statistically significant difference between the two groups in the accuracy rate of the treatment of abnormal index in the auxiliary examination of chemotherapy(χ2=20.182,P<0.01). Patients in the intervention group actively reported their physical condition and examination results to the case manager for a total of 1020 times,compared with 210 times in the control group. Conclusions The application of chemotherapy management table in breast cancer case management mode can improve the compliance of postoperative chemotherapy auxiliary examination of breast cancer patients,improve the ability to deal with abnormal examination indicators,improve the enthusiasm of patients' active consultation and the work efficiency of case managers.

Objective:To investigate the satisfaction levels of the rural elderly in Dafeng district of Yancheng, Jiangsu province with the contracted family doctor services, and to identify the factors that influence their satisfaction.The findings of this study will provide valuable insights for improving the quality of the contracted family doctor services offered to the rural elderly population.Methods:The study utilized the stratified cluster sampling method to select elderly individuals aged 60 years and above from Dafeng district, Yancheng city for a questionnaire survey.Specifically, the study focused on elderly individuals who had participated in contracted family doctor services for more than six months.The survey aimed to gather information on the elderly population's general situation, as well as their understanding, utilization, and satisfaction with contracted family doctor services.The satisfaction of contracted family doctor services was analyzed using the chi square test and multivariate Logistic regression to identify the influencing factors.Results:The study surveyed 385 elderly individuals from rural areas who had contracted family doctor services.The results showed that 88.3%(340/385)of respondents were satisfied with the services they received.Additionally, 99.2%(382/385)of those surveyed were aware of the contracted family doctor services, and 81.8%(315/385)had received basic medical services from their signed-up doctors.The results of a multifactor analysis that examined the factors influencing the overall satisfaction of elderly patients with their contracted family doctor services revealed several significant factors.Specifically, being female( OR=2.557, 95% CI: 1.122-5.830, P=0.026)and unmarried( OR=7.355, 95% CI: 1.850-29.237, P=0.005), supporting the contracted family doctor services system( OR=18.442, 95% CI: 1.732-195.973, P=0.016), believing that the contracted medical institutions had excellent hardware facilities( OR=9.918, 95% CI: 2.313-42.526, P=0.002)and providing high-quality health services for the elderly( OR=8.723, 95% CI: 1.556-48.908, P=0.014), as well as experiencing improved health status after signing the contract( OR=5.006, 95% CI: 1.764-14.201, P=0.002)were all significant factors influencing their satisfaction.These findings suggest that these factors are important considerations for improving the satisfaction of elderly patients with their contracted family doctor services. Conclusions:The contracted family doctor services provided in Dafeng district, Yancheng city have been well received by the rural elderly population.Factors such as gender, marital status, attitude towards the contracted family doctor services system, improvements in health status after contracting the service, quality of the hardware facilities at the contracted medical institution, and availability of health services specifically tailored for the elderly all play a role in determining the level of satisfaction among the contracted elderly population.To better serve the elderly population, it is crucial that we prioritize their needs.This can be achieved by improving the level of "suitable aging" in the contracted services and enhancing the satisfaction of family doctors who provide these services.

Objective:In order to develop an appropriate care service system and care security system for the elderly in urban communities, it is necessary to gain a comprehensive understanding of their needs and utilization of care services, as well as the cost of care and the factors that influence it.This will provide a theoretical basis for developing effective countermeasures.Methods:A stratified random cluster sampling method was utilized to conduct a questionnaire survey on individuals aged 60 and above in the Xuzhou urban community.The survey aimed to gain insight into the needs, utilization, and expenditure of care services for the elderly.To analyze the factors influencing care expenditure, a single factor χ2 test and Tobit regression model were employed. Results:In our survey of 1 623 elderly individuals, it was found that 32.4%(526 people)had been bedridden for more than one day in the past year and were unable to care for themselves.Of the elderly who are bedridden, 393 individuals(74.7%)have received care services from professional institutions, with a focus on medical care(312 people, 79.4%)and rehabilitation care(95 people, 24.2%).In terms of financial expenditures, 91.7% of respondents(1 489 people)reported spending zero yuan in the past year, while 6.0%(96 people)spent between 1 and 4 999 yuan.Only 1.0%(17 people)reported spending between 5 000 and 9 999 yuan, and 1.3%(21 people)spent 10 000 yuan or more.The findings from the univariate analysis revealed that various factors, including marriage, age, medical expenses, and life satisfaction had a significant impact on the care expenses of the elderly(all P<0.05).Furthermore, the Tobit regression model demonstrated that certain variables were particularly influential in determining care expenses.Specifically, elderly individuals with higher monthly income(Me=3.114), advanced age(Me=3.458), knowledge of care insurance(Me=7.647), disability(Me=10.998), no spouse(Me=14.387), and dementia(Me=20.473)had significantly higher care expenses. Conclusions:The survey conducted in Xuzhou suggests that the demand for care services is high, yet the utilization rate remains low, leading to a significant burden of care costs.To address these challenges, we must prioritize the care needs of disabled, mentally retarded, and advanced-age elderly individuals.We should also focus on enhancing medical and rehabilitation care services, improving the overall quality of elderly care, and promoting the development of a comprehensive elderly care service system and care security system that caters to the specific needs and financial constraints of the elderly population.

Objective:To explore the long-term effect of endoscopic radiofrequency ablation for the treatment of unresectable ampullary carcinoma.Methods:Clinical data of patients with ampullary carcinoma who received endoscopic radiofrequency ablation in the Third Affiliated Hospital of Naval Medical University from January 2012 to May 2019 were retrospectively collected, including basic information, frequency of radiofrequency ablation, the type of biliary stent, postoperative complications, and follow-up. Kaplan-Meier method was used to analyze the survival of patients after endoscopic radiofrequency ablation. Relationship between frequency of radiofrequency ablation, type of biliary stent and overall survival time was analyzed.Results:A total of 50 patients were enrolled, including 31 males and 19 females, aged 73.0±9.7 years. Twenty-five patients (50.0%) underwent 1 radiofrequency ablation treatment, while 25 patients (50.0%) underwent radiofrequency ablation treatments more than twice. Postoperative complications occurred in 6 patients (12.0%), all of which were mild symptoms. The average follow-up was 22.3 months, with a total of 39 (78.0%) deaths, 5 (10.0%) lost to follow-up, and 6 (12.0%) surviving. The median overall survival time was 16.9 (95% CI: 9.1-24.8) months, with cumulative survival rates of 62.0%, 38.5%, 27.0%, and 12.6% at 1, 2, 3, and 5 years, respectively. The median overall survival time of those treated with radiofrequency ablation ≥2 times showed a trend of prolongation compared to patients treated once, but the difference was not statistically significant [26.7 (95% CI: 9.7-43.7) months VS 12.6 (95% CI: 4.9-20.3) months, χ2=3.049, P=0.081]. Plastic stents were used in 32 patients (64.0%) and metal stents in 18 patients (36.0%). There was no significant difference in median overall survival time between patients using metal and plastic stents [17.1 (95% CI: 6.1-28.0) months VS 15.9 (95% CI: 6.9-24.9) months， χ2=0.029， P=0.865]. Conclusion:Endoscopic radiofrequency ablation is a safe treatment for unresectable ampullary carcinoma, and multiple consecutive treatments may increase the survival benefit.

Objective:To investigate the efficacy of endoscopic stent placement for patients with Bismuth type Ⅳ hilar cholangiocarcinoma.Methods:Data of 229 patients with unresectable Bismuth type Ⅳ hilar cholangiocarcinoma who successfully underwent endoscopic stent placement at the Department of Endoscopy, the Third Affiliated Hospital of Naval Medical University from January 2002 to January 2019 were retrospectively analyzed. Outcomes included clinical success rate, complication incidence, stent patency period and overall survival time. The patency of stents and overall survival time of patients were estimated by using the Kaplan-Meier method. The independent predictors for stent patency and overall survival of patients were analyzed by a multivariate Cox proportional regression model.Results:The overall clinical success rate was 78.2% (179/229). The incidence of early cholangitis after endoscopic retrograde cholangiopancreatography was 20.5% (47/229). The median stent patency and overall survival time were 5.7 (95% CI: 4.8-6.7) months and 5.1 (95% CI: 4.2-6.0) months, respectively. Further multivariate Cox regression analysis showed that metal stent ( P<0.001, HR=0.452, 95% CI: 0.307-0.666) and bilateral stents with bilateral angiography ( P=0.036, HR=0.644, 95% CI: 0.427-0.971) were independent predictors of stent patency; total bilirubin>200 μmol/L ( P=0.001, HR=1.627, 95% CI: 1.208-2.192), metal stent ( P=0.004, HR=0.636, 95% CI: 0.467-0.866) and antitumor therapy ( P<0.001, HR=0.439, 95% CI:0.308-0.626) were independent predictors of overall survival. Conclusion:There is high incidence of cholangitis in patients with unresectable Bismuth type Ⅳ hilar cholangiocarcinoma treated with endoscopic stenting. Longer stent patency can be achieved with metal stent placement and bilateral drainage. In addition, metal stent for drainage and antitumor therapy can also help increase the survival benefit.