AIM:To study the effect of different quantities of carboxymethyl chitosan(CMCT) modification to the pharmacokinetic performance of PTX-LP in rats.METHODS:Plasma was extracted with tert-butyl methyl ether and Norethisterone was employed as internal standard after i.v.unmodified PTX-LP,(0.1)%CMCT modified PTX-LP and(0.2)%CMCT modified PTX-LP in rats.Plasma samples were analyzed on a C_(18) column at 227 nm and the mobile phase was methanol and water(6535,v/v).RESULTS:The plasma concentration-time profile in rats after iv.unmodified PTX-LP,(0.1)% CMCT modified PTX-LP and(0.2)% CMCT modified PTX-LP follow bi-exponential disposition.T_(1/2?) are(11.20),(15.55) and(30.6) h respectively,AUC were(2541.99),(2748.78) and(3451.64)(mg?L~(-1)?min) for each of them.CONCLUSION:Significant changes of in vivo pharmacokinetic performance have been found after CMCT modification to PTX-LP in rats by comparison with unmodified LP.T_(1/2?) and circulation time in plasma have been lengthened and AUC has been improved in some extent.We found that this kind of long circulating action had some correlation with the quantities of CMCT employed.

OBJECTIVE: To investigate the effect of balloon kyphoplasty combined with bone cement on the treatment osteoporotic vertebral fracture.METHODS: A total of 58 aged patients with single osteoporotic vertebral compression fracture (58 vertebral bodies) were treated with balloon kyphoplasty. The fracture always occurred at T_8-L_4 segment of vertebral body in particular at T_(10)-L_2 segment of thoracic waist. By local anesthesia, lateral or bilateral pedicle of vertebral arch was punctured to injection bone cement under C-arm fluoroscopy.RESULTS: Bone cement leakage occurred in 8 cases, including leakage along posterior longitudinal ligament into adjacent posterior margin of vertebral body (n=1), external edge of vertebral body (n=6), and subcutaneous tissue (n=1); however, all the patients did not have clinical symptoms. C-arm fluoroscopy showed that height of vertebral body was increased, and rachiokyphosis was improved after treatment. Pain was obviously improved, and the easement rate of pain was 100%. There was significant difference in visual simulation score, angle degree of rachiokyphosis, and living activity scale before and 6 months after treatment (P < 0.05), but there was no significant difference between 6 months after treatment and following up stopping (P>0.05).CONCLUSION: Balloon kyphoplasty can significantly ease pain caused by osteoporotic spinal fractures and tumor metastatic spinal fractures and can partially restore vertebral body height and kyphosis deformity, there is conducive to improving spinal function and improving the quality of life.

OBJECTIVETo explore the interaction between inheritance and environment with the aid of research on the genetic modes of hepatocellular carcinoma (HCC).

METHODSA genetic epidemiological study of HCC was conducted based on the methods of Penrose, simple segregation and Falconer for 100 proband pedigrees from HBsAg positive cohort. The proband samples came from a cohort of 90,00 people who were followed for 8 years. Analyses on genetic modes were carried out and heritability was calculated through the comparison of the proband pedigrees incidence frequency with incidence frequencies of the cohort and general population.

RESULTSThe incidence frequency of first-degree relatives was 4.0%, higher than what was seen in the general population incidence frequency (0.44%) and the cohort (1.03%). A familial aggregation of HBsAg carriers and a strong positive correlation between HBsAg carrier status and HCC were noticed (OR = 8.44, 95% CI: 3.37-20.06, P < 0.001). A ratio of the incidence frequency among siblings to the incident frequency among general population (s/q) approached 1/q(1/2) by Penrose method, but simple segregation did not show agreement with single-gene inheritance. The heritability from positive cohort was 42% +/- 6% (P < 0.05), compared with the heritability (59% +/- 7%) of general population. When the effect of the HBsAg was under control, the heritability from positive cohort turned to be 29% +/- 8% (P < 0.05), compared with the heritability (47% +/- 7%) of general population.

CONCLUSIONOur findings suggested that HCC followed a multifactorial mode rather than single inheritance. An interaction effect of inheritance and environment on HCC was also noticed.

Carcinoma, Hepatocellular ; epidemiology ; genetics ; China ; epidemiology ; Environment ; Female ; Hepatitis B Surface Antigens ; analysis ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; genetics ; Male

Objective A prospective cohort study was carried out to assess the mortality and potential risk factors for primary liver cancer (PLC) in Haimen city of Jiangsu province.Methods The cohort involved 89 789 adult residents aged 25-69 years.Upon the entry of this project,each subject was asked to complete a questionnaire and to provide a blood sample of 10 ml.Surface antigen of hepatitis B virus (HBsAg) was tested by radioimmunoassay.All the subjects were followed-up every year for vital statistics and death certificate information until 2014.Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95％ confidence interval (95％ CI) for PLC mortality associated with HBsAg status and other risk factors.Results During the 1 299 611 person-years of follow-up,a total of 2 583 PLC cases were identified,including 2 149 men and 434 women.Mortality of the PLC for men and women were 247.80/100 000 person-years and 100.38/100000 person-years,respectively.Among those who died of PLC,73.87％ had been tested HBsAg positive.HBV infection seemed the predominant risk factor for PLC and the HRs were 15.97 for men (95％CI:14.29-17.85) and 21.63 for women (95％CI:16.16-28.96) respectively.Ageing,cigarette smoking,previous history of hepatitis,and family history of HCC were factors associated with the increased risk for PLC.Conclusion People living in Haimen city had a high risk on PLC.HBV infection appeared the most important risk factor for HCC mortality in this area.

Objective To compare the clinical effect and safety of transcatheter arterial chemoembolization (TACE) combined with 125I seed implantation with those of pure TACE in treating primary liver cancer (PHC) complicated by portal vein tumor thrombus (PVTT) . Methods Computer and manual retrieval of PubMed, Cochrane Library, CBM, Wan Fang Database, China National Knowledge Internet and other databases was conducted to collect the retrospective cohort studies on the comparison of the clinical effect and safety of the combination use of TACE and 125I seed implantation with those of simple TACE in treating PHC complicated by PVTT, from which the relevant data were extracted. The quality of extracted documents was assessed according to the standard of Cochrane manual. Results A total of eight articles containing 822 patients were included in this study. Meta analysis indicated that both the effective rate and disease control rate for PHC complicated by PVTT in TACE plus 125I seed implantation group were significantly higher than those in pure TACE group, and the differences between the two groups were statistically significant (P<0.05) . The half-year, one-year and 2-year survival rates of TACE plus 125I seed implantation group were better than those of pure TACE group, and the differences between the two groups were statistically significant (P<0.05) . No statistically significant differences in the incidence of severe complications existed between the two groups (P>0.05) . Conclusion In treating PHC complicated by PVTT, the curative effect of TACE plus 125I seed implantation is superior to pure TACE. No obvious difference in the incidence of severe complications exists between the two groups.

Objective To explore the diagnosis and treatment method of peripelvic cysts.Methods A retrospective analysis was conducted on 65 patients with peripelvic cysts admitted to the Department of Urology at Shanghai Xuhui Central Hospital from January 2019 to January 2023.The diagnostic value of ultrasound,intravenous urography(IVU),and computed tomography urography(CTU)for peripelvic cysts was compared,and the efficacy of different surgical treatments for peripelvic cysts was further evaluated.Results All 65 patients underwent ultrasound examination,which indicated cystic lesions at the renal hilum.55 patients underwent IVU examination,but no cyst enhancement was found.Among them,7 patients underwent retrograde pyelography due to poor imaging of the affected renal pelvis.All 53 patients who underwent CTU examination,which clearly showed the renal pelvis and cysts.Among the 65 patients,5 did not undergo surgical treatment and were followed up,while 60 underwent surgery.Four patients were considered for radical nephrectomy due to suspected malignancy.56 cases underwent renal cysts decompression surgery,including 11 open surgeries,37 laparoscopic surgeries,and 8 Da Vinci robot-assisted laparoscopic surgeries.The operative time in the open surgery group was significantly shorter than that in the laparoscopic surgery group and robot-assisted laparoscopic surgery group.Compared with the open surgery group and laparoscopic surgery group,the robot-assisted laparoscopic surgery group had less intraoperative blood loss,lower postoperative analgesic use,shorter time to first ambulation after surgery,and shorter hospital stay.Conclusions Ultrasound,IVU,and CTU are commonly used effective diagnostic tools for peripelvic cysts.Ultrasound can be used as a routine examination,while CTU is more accurate and has a higher diagnostic accuracy than IVU for this condition.Compared with open surgery,laparoscopic and robot-assisted laparoscopic cyst decompression surgery for peripelvic cysts result in less intraoperative blood loss and faster postoperative recovery.

Objective To analyze the effect of the new conformal index(nCI)and the conventional conformal index(CI)on the treament planning quality of lung stereotopic radiotherapy(SBRT).Methods A total of 19 peripheral lung cancer patients,treated with SBRT in Fujian Medical University Union Hospital from 2014 to 2017,were analyzed retrospectively.Each patient was planned twice yielding identical CI and nCI.The prescription to 95％of planning target volume(PTV)was 48 Gy in four fractions,and renormalization was performed when needed for nineteen nCI plans.The Wilcoxon signed-rank test was used to examine the dosimetric index.Results The dose conformity plots indicate that nCI does not only reflect the dose to the organ at risk outside tumor,but also represents the dose distribution in the PTV.In addition,nCI was stricter with treatment planning qualities when the dose around PTV was closer to the prescribed dose.The value of target coverage(TC),the ratio of out-of-target volumes receiving 105％prescribed dose to the target volume(R105％),the ratio of volume covered by 50％isodose line to the target volume(R50％),and the ipsilateral lung V20were 98.70％,0.56,5.53,15.59％in the CI plans,vs.90％,0,4.99,14.42％in the corresponding nCI plans,respectively.All index were significantly lower in the nCI group(Z ＝-3.823,-3.180,-3.823,-3.783,respectively,P＜0.05).The ratio of the maximum dose to the 2 cm external margin from the PTV(D2 cm)to the maximum dose to the PTV were 63.70％and 64.07％respectively in the two groups,and the differences were not statistially significant(P＞0.05).The conformity values denoted a clinically favorable value as 1 between D95％and D99％of nCI plans,yet were not applicable to CI plans.Conclusions It is more clinically relavant to evaluate lung SBRT plans using nCI,TC and other indicators collectively than using CI alone.

Objective To establish an evaluation method of uncertainty for the determination of lead in ambient air PM_2.5 by inductively coupled plasma mass spectrometry (ICP-MS). Methods According to HJ657-2013 ^“Determination of Lead and Other Metal Elements in Air and Exhaust Particulates by Inductively Coupled Plasma Mass Spectrometry^”, the concentration of lead in ambient air PM2.5 was determined. A mathematical model was established to analyze the source of uncertainty and to calculate each component of uncertainty. The components were combined into the standard uncertainty, and the relative expanded uncertainty was finally obtained. Results The expanded uncertainty of lead in ambient air PM2.5 was 0.16 ng/m³, and the measurement result of lead was (1.75±0.16)ng/m³. Conclusion The main source of uncertainty of this method comes from the relative standard uncertainty introduced by sample pretreatment.

Objective To investigate the nutrient contents of various grains in Hubei Province, and to provide a scientific basis for a balanced diet. Methods Various grains (except potatoes and beans) on the market in Hubei Province were collected. The samples were prepared by peeling and milling, or directly milling, and the nutrient contents were determined according to the national standard methods. With reference to the American nutrient profiling model, protein, dietary fiber, vitamin C, vitamin A, vitamin E, potassium, magnesium, iron and calcium, the nine nutrients were selected as recommended nutrients, and sodium, added sugars and fat were restricted nutrients. On the basis of 100 g for calculation, a nutrient-rich food model (Nutrient-rich foods, NRF_9.3) was established and applied to evaluate the grains. Results The evaluation results showed that wheat and buckwheat grains contained a higher recommended nutrient content than restricted nutrient content, and had higher nutritional value. Among them, quinoa (black) had the highest NRF index of 102.4, indicating the most nutritional value. After peeling, the loss rate of nutrient value (NRF_9.3 index) of various grains was 38.73% to 65.00%. Conclusion It is recommended that people should try to choose whole grains when purchasing grain products.