From 1990 to 1992, 41 patients with ulcerating or fistulized esophageal carcinoma (EC) were treated by the conventional irradiaton after a nasogastric tube was inserted into the esophageal lumen. The total doses were 60～65GY/6～6.5WKS. The results were: 1/1 CR in patients with small ulcer, 10/13 CR and 2/13 PR in patients with medium-sized ulcer, 2/7 CR and 3/7 PR in patients with large ulcer, 3/10 CR and 5/10 PR in patients with esophageal mediastinal fistula and 1/10 CR and 4/10 PR in patients with esophagel tracheal or bronchial fistula. The total remission rate was 75.6%(31/41). The 1-and 2-year survival rates were 42.8%, 26.6% for EC with ulcer and 25%, 10% for EC with fistula, respectively.

Objective:To establish the quality standard for Isatidis folium dispensing granules. Methods:Indigo and indirubin in the granules were identified by TLC. The extract content was determined by a hot dipping method for the determination of alcohol-solu-ble extract. The content of indirubin was determined by HPLC. Results:The spots in TLC were clear and well-separated. The extrac-tion limit no less than 12. 0% was preliminarily drawn up. Indirubin showed a good linear relationship within the range of 0. 50-8. 04μg·ml-1(r=0. 999 9) with the average recovery of 99. 41%(RSD=1. 21%, n=9). The content limit no less than 50. 0 μg per pack was preliminarily drawn up for indirubin. Conclusion: The method is easy-operated and accurate with good specificity for the quality control of Isatidis folium dispensing granules.

Objective To establish the quality standard of common selfheal fruit-spike granules. Mehtods Rosmarinicacid in the granules were identified by TLC. The extractives were tested by the method for determination of water-soluble extractives. The contents of rosmarinicacid were determined by HPLC. Results TLC had obvious characteristics with the spots clear and well-separated. The extraction limit was no less than 10.0%. Rosmarinicacid showed a good linear relationship at 0.062 5~2.008 0 mg/ml (r=0.999 8,n=6) with average recovery of 99.50% (RSD=1.21%,n=9). The content limitation of rosmarinicacid was discussed as 10.0 mg per pack according to the experiment data.Conclusion The method is easy-operated and accurate which has a good specificity for the quality control of common selfheal fruit-spike granules.

OBJECTIVE:To establish the quality standard of Banlangen dispensing granules. METHODS:Thin layer chroma-tography(TLC)was used to identify Isatis indigotica,leucine and arginine,the items according to granules preparations and the ex-traction were detected. HPLC was conducted to determine the content of (R,S)-goitrin. The Shimadzu VP-ODS C18 column was used with the mobile phase of methanol-0.05% phosphoric acid (7∶93,V/V) at the flow rate of 1.0 ml/min. The detection wave-length was set at 245 nm,and the column temperature was room temperature. The sample size was 10 μl. RESULTS:TLC showed clear spots and good resolution. Particle size,moisture,dissolubility and microbial limit test were all conformed to the specifica-tion. The extraction limit was no less than 25.0%.(R,S)-goitrin showed a good linear relationship in the range of 1.565 9-50.109 8μg/ml(r=0.999 9,n=6). The average recovery was 99.25%(RSD=2.08%,n=9);the RSDs of precision,stability and repeatabili-ty tests were no more than 1.12%. The content of(R,S)-goitrin was initially determined as 0.35 mg/g. CONCLUSIONS:The estab-lished quality standard has increased content determination,and the control programs are more comprehensive and reasonable. It can be used for the quality control of Banlangen dispensing granules.

Objective:To establish the method for the determination of emodin and danshensu Pinggan oral liquid. Methods:The contents were determined by HPLC. The chromatographic conditions for emodin were as follows: an Agilent Eclipse XDB-C18 column (150 mm × 4. 6 mm, 5μm) was used and the mobile phase was methanol-water (80 ∶20). The detection wavelength was 287 nm and the flow rate was 1. 0 ml·min-1 . The column temperature was 25℃ and the injection volume was 20 μl. The chromatographic condi-tions for Danshensu were as follows:an Agilent Eclipse SB-C18 column (150 mm × 4. 6 mm, 5 μm) was used and the mobile phase was methanol-1% acetic acid solution (2 ∶98). The detection wavelength was 280 nm and the flow was 1. 0 ml·min-1. The column temperature was 30℃ and the injection volume was 20 μl. Results:Emodin had a good linear relationship within the range of 26. 75-428. 00 μg·ml-1(r=0. 999 9). The average recovery was 102. 7% and RSD was 0. 76% (n=6). Sodium Danshensu had a good linear relationship within the range of 10.17-162.77 μg·ml-1(r =0.999 9). The average recovery was 100.5% and RSD was 1. 47% (n=6). Conclusion:The method is simple, accurate and reproducible, which can be used for the quality control of the prep-aration.

Objective To investigate the clinical effect of laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors.Methods Retrospectively review the clinical data of 35 patients suffering multiple segmental intraspinal tumors,who underwent the laminoplasty with bone grafting for intraspinal tumor resection in Department of Neurosurgery,Clinical Medical College of Yangzhou University,from June 2013 to May 2016.Observation indicators:(1) surgical and postoperative recovery situations,including tumor resection,number of lamina reset,tumor pathological results,clinical efficacy evaluation,complications,etc;(2) follow-up situations,including spinal stability evaluation,rate of bone graft fusion,tumor recurrence.Follow-up using outpatient examination and telephone interview was performed by the end of December 2017.Results (1) Surgical and postoperative recovery situations:of the 35 patients,31 achieved total tumor resection,3 subtotal tumor resection and 1 partial tumor resection.There were no spinal dura mater injuries when laminectomy was performed,and 84 laminae were repositioned and implanted.The neurological function of the spinal cord was evaluated based on McCormick scoring system:32 cases were improved and 3 cases were controlled.Incision healing was bad in 2 patients,and cerebrospinal fluid leakage occurred in 1 case,which all recovered after treatment.(2) Follow-up situations:all the 35 patients were followed up for 8 to 36 months,with a median time of 14.2 months.Imaging examination more than 6 months after operation:no spinal instability was found in standing spine X-ray examination;CT scan showed a total of 142 sides in the 84 vertebral plates (168 sides) had achieved bone fusion,the fusion rate was 84.5％,and no titanium nail removal and connecting piece shift was found;MRI showed no tumor recurrence in all patients.Conclusion Use of the laminoplasty technique with bone grafting in the treatment of multiple segmental intraspinal tumors can achieve good clinical efficacy,high fusion rate for resected laminae and satisfactory spinal stability.

Objective To explore the influencing factors of cognitive dysfunction in patients with mild to moderate traumatic brain injury(TBI)and to establish a prognostic nomogram model.Methods A retrospective study was performed on 301 patients with mild to moderate TBI.Patients were divided into two groups according to whether the patients had cognitive dysfunction evaluated by the Montreal Cognitive Assessment Scale(MoCA).Independent influencing factors affecting long-term cognitive deficits in mild to moderate TBI patients were analyzed by Logistic regression analysis.A nomogram model for predicting the risk of cognitive deficits was established by using R software,and the predictive performance and compliance of the model were evaluated by using the consistency index(C-index)and the calibration curve.Results Among 301 patients with mild to moderate TBI,122 patients had long-term cognitive dysfunction,with an incidence rate of 40.5%.Multivariate analysis showed advanced age,lower GCS score,hyperlipidemia,contusion of the temporal lobe,subarachnoid hemorrhage,ICU admission were independent risk factors for cognitive dysfunction in mild to moderate TBI patients(all P＜0.05).More than 12 years of education and very early rehabilitation were independent protective factors for cognitive dysfunction in mild to moderate TBI patients(all P＜0.05).The nomogram model established based on the above 8 influencing factors had good predictive performance,and the nomogram model had a high predictive accuracy with a C-index of 0.845.Conclusions The probability of cognitive dysfunction in patients with mild to moderate TBI should be predicted through the nomogram model according to age,GCS score,hyperlipidemia,contusion of the temporal lobe,subarachnoid hemorrhage,ICU admission,education level and very early rehabilitation.The nomogram model could be used to guide assessment and intervention for improving prognosis of the patients.

Objective:To explore the risk factors for shunt dependent hydrocephalus (SDHC) in patients with traumatic subarachnoid hemorrhage (tSAH) and establish their risk nomogram model.Methods:Two hundred and sixty-nine patients with tSAH, admitted to our hospital from February 2018 to February 2022, were chosen in our study. All patients were followed up for 3 months after discharge; 51 patients were complicated with SDHC and 218 patients were not complicated with SDHC. The clinical data of patients with and without SDHC were compared. Multivariate Logistic regression analysis was used to determine the independent influencing factors for SDHC in tSAH patients; according to the results of multivariate Logistic regression analysis, a nomogram model was constructed to predict SDHC in tSAH patients; and the consistency index (C-index) and calibration curve were used to evaluate the predictive performance and compliance of the nomogram model.Results:As compared with patients without SDHC group, patients with SDHC had significantly lower Glasgow Coma Scale (GCS) scores on admission, and significantly higher proportions of patients with cerebral hernia, diffuse tSAH, tSAH thickness ≥5 mm, intraventricular hemorrhage, midline shift>12 mm, and epidural effusion at discharge, and patients accepted decompressive craniectomy ( P<0.05). Multivariate Logistic regression analysis showed that GCS scores of 13-15 ( OR=0.134, 95%CI: 0.024-0.740, P=0.021), diffuse tSAH ( OR=4.391, 95%CI: 1.680-11.475, P=0.003), tSAH thickness≥5 mm ( OR=4.114, 95%CI: 1.689-10.018, P=0.002), decompressive craniectomy ( OR=3.283, 95%CI: 1.278-8.433, P=0.014) and epidural hydrops ( OR=3.302, 95%CI: 1.137-9.593, P=0.028) were independent influencing factors for SDHC in tSAH patients. A nomogram model established based on the above 5 influencing factors showed high predictive accuracy with C-index of 0.877. Conclusion:The tSAH patients with low GCS scores at admission, diffuse tSAH, tSAH thickness≥5 mm, and epidural effusion, and patients accepted decompressive craniectomy are prone to have SDHC; the nomogram model based on the above variables has a high efficiency in predicting the risk of tSAH complicated with SDHC.

Platinum-based chemotherapy resistance is a key factor of poor prognosis and recurrence in hepatocellular carcinoma (HCC). Herein, RNAseq analysis revealed that elevated tubulin folding cofactor E (TBCE) expression is associated with platinum-based chemotherapy resistance. High expression of TBCE contributes to worse prognoses and earlier recurrence among liver cancer patients. Mechanistically, TBCE silencing significantly affects cytoskeleton rearrangement, which in turn increases cisplatin-induced cycle arrest and apoptosis. To develop these findings into potential therapeutic drugs, endosomal pH-responsive nanoparticles (NPs) were developed to simultaneously encapsulate TBCE siRNA and cisplatin (DDP) to reverse this phenomena. NPs (siTBCE + DDP) concurrently silenced TBCE expression, increased cell sensitivity to platinum treatment, and subsequently resulted in superior anti-tumor effects both in vitro and in vivo in orthotopic and patient-derived xenograft (PDX) models. Taken together, NP-mediated delivery and the co-treatment of siTBCE + DDP proved to be effective in reversing chemotherapy resistance of DDP in multiple tumor models.