Objective To compare the clinical efficacy of nedaplatin and cisplatin combined with docetaxel in the treatment of cervical cancer.Methods 80 patients with cervical cancer were selected as the research subjects.According to different chemotherapy regimens,they were divided into observation group(40 cases)and control group(40 cases).The observation group adopted nedaplatin combined with docetaxel chemotherapy regimen,while the control group used cisplatin plus docetaxel chemotherapy regimens.The clinical curative effect,adverse reaction of chemotherapy,hospitalization related indicators,etc were compared between the two groups.Results The total effective rate of the observation group was 85.0%,which of the control group was 77.5%,the difference was not statistically significant(x2=0.739,P=0.739).The incidence rate of gastrointestinal reaction(Ⅰ-Ⅳ)in the observation group was 25.0%,which was lower than 82.5% in the control group(x2=26.560,P=0.000).The incidence rate of renal toxicity(grade Ⅰ-Ⅱ)of the observation group was 2.5%,which was lower than 17.5% of the control group(x2=5.000,P=0.025).The length of hospital stay of the observation group was(2.93 ±0.39)days,which was shorter than(4.97 ±0.81)days of the control group(t=14.352,P=0.000).The incidence rate of bone marrow inhibition(grade Ⅰ-Ⅱ)of the observation group was 43.0%,which was significantly higher than 25.0% of the control group(x2=4.381,P=0.036).1 year overall survival(OS),no local recurrence rate(LRF)and no distant metastasis survival rate(DMF)between the two groups had no statistically significant differences(all P>0.05).Conclusion Efficacy of nedaplatin or cisplatin combined with docetaxel in adjuvant chemotherapy of cervical cancer has similar prognosis,nedaplatin has less toxicity,and can shorten the time of hospitalization,patients are more likely to accept,it is worthy of clinical promotion.

Objective To study the feasibility of a novel probe 99Tcm-HYNIC-2(poly-(ethylene glycol),PEG) 4-Dimer (Dimer:E-[c (RGDfK) 2]) as a potential imaging agent for integrin αv β3 positive tumors,and also to observe the influence of an angiogenesis inhibitor,endostar,on the biodistribution and tumor uptake of the tracer in tumor bearing nude mice.Methods The expression of integrin αv β3 in human glioma cells U87MG was determined with immunofluorescence staining before and after treatment with endostar.99Tcm-HYNIC-2PEG4-Dimer was prepared and administered in U87MG tumor bearing mice in 6 h after either administration of endostar (200 μl) or saline (control group) and then biodistribution study was performed.Other 16 mice were divided into endostar treated group (20 mg/kg) and control group (saline) and then gamma imaging was performed in the two groups.Statistical significance of differences between the two groups was assessed using two-sample t test.Results Radiochemical purity of 99Tcm-HYNIC-2PEG4-Dimer was exceeded 95％.The expression of integrin αvβ3 in U87MG cell was high and gradually decreased after treatment with endostar.There was a negative dose-effect relationship between the dose of endostar and the expression of integrin αvβ3 with the peak effect at the dose of 400 μg/ml.The distribution study in vivo showed that the tracer uptake of U87MG tumors was high,but it decreased after injection of endostar.At 90 min,the ％ID/g of endostar and control groups were 1.50±0.08 and 6.27±0.33,respectively (t =40.23,P＜0.05).The average T/NT ratios of 99Tcm-HYNIC-2PEG4-Dimer uptake in the endostar and control groups were 1.02±0.11 and 2.58±0.36,respectively (t =10.25,P＜0.05).The integrin αv β3 positive expression ratios of tumor in endostar and control groups were (33.1 ±2.7) ％ and (81.5±3.2) ％,respectively (t =32.60,P＜0.05).Conclusions The novel probe 99Tcm-HYNIC-2PEG4-Dimer may be a promising radiotracer for integrin αvβ3-positive tumor imaging.It may be used for monitoring the therapeutic effect of endostar and may be potentially used for screening the candidates of anti-angiogenesis therapy.

Objective To study to take the oxidized Mannan?modified 786?0 in renal clear cell carcinom as tumor cells antigen to sensitize Dendrit?ic cells(DC)and to observe the its killing effect on renal clear cell carcinoma of CTLs induced. Methods Getting the peripheral blood mononucle?ar cells from the volunteers,and then to be stimulated to turn to be maturation by GM?CSF and IL?4 in vitro. Taking the clear renal carcinoma cell as the tumor antigen,and then making it to be modified by oxidized Mannan to acquire the tumor cell vaccine.Experimental groups include:blank group:DC?PBS group,control group:control?DC?786?0,experimental group:DC?Ox?Mannose?786?0 group. Taking the flow cytometry to detect the changes of DC phenotype,then taking the ELISA to detect the sencretion levels of supernatant of IL?12 of DC,then taking the CCK to detecte the cytotoxicity of lymphocytes(CTL)induced by DC of these experiment groups. Results Results by flow cytometry:the mature phenotype of DCs sensitized by Ox?Mannose?786?0 group included CD80,CD83,CD86 and HLA?DR expressed significantly higher than the other groups. As well as the secretion levels of IL?12. Meanwhile the cytotoxicity activity of lymphocytes(CTLs)induced by DCs which are sensitized by Ox?Mannose?786?0 increased more significantly than the other groups. Conclusion Glycosylated Antigens can be more effective in sensitizing antigen?presenting cells DC,and stimulating them to be maturation,while the killing effect to tumor cells also have noticeably improved.

Objective:To investigate the dynamic changes of glycine (Gly) and taurine (Tau) in corpus striatum of rats with ischemia-reperfusion injury (IRI),and the regulation effect of electroacupuncture on them.Methods:Thirty SD rats were randomly divided into sham surgery group,model group,and treatment group.Rats in the sham surgery group were operated without ischemia.Rats in the model group and treatment group were operated to make model of cerebral IRI.The ischemia status lasts 1.5 h,and reperfusion was performed for 3.75 h.Rats in the treatment group were treated with electroacupuncture at Fengchi (GB 20).Neurologic deficit score (NDS) was used to evaluate the rats functions.Microdialysis and High Performance Liquid Chromatography technique were used to detect the changes of Gly and Tau in corpus striatum of rats.Results:Contents of Gly and Tau increased at 1.5 h after ischemia.Them decreased to level as same as those rats in the sham surgery group after reperfusion.The content of Gly in the model and treatment group increased again at 2-2.5 h after reperfusion,and then decreased to the same level of the sham surgery group.There was a third increase of Gly content in the treatment group at 2.75 h after reperfusion.Electroacupuncture treatment could delay the decrease of Tau content after reperfusion,and make it increase at 1.5,2 and 2.75 h after reperfusion.The peak appeared in the last time.NDS in the model and treatment group were more than that in the sham surgery group,and lowered at 5.25 h after surgery.Effects in treatment group was better than that in the model group (P＜0.05).Conclusion:IRI makes contents of Gly and Tau in corpus striatum increase at a special time.Electroacupuncture treatment could increase contents of Gly and Tau at a special time after reperfusion,which maybe an important mechanism of protecting effects of electroacupuncture on the brain.

Objective:To assess the efficacy of immunosuppressor on treatment of Henoch-Sch?nlein purpura nephritis(HSPN).Methods:Literatures were searched in PubMed, Cochrane library, Web of Science, Wanfang database, CNKI and CBM database from inception to January 2021.The studies that investigated the effect of immunosuppressor on HSPN outcomes were included.Article screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by STATA 14.Results:Ten studies were included with 443 cases, of which, 245 cases were in the experimental group while 198 cases were in the control group.The Meta-analysis showed that the experimental group had higher complete remission rate( OR=1.95, 95% CI 1.19-3.22, P=0.009), total remission rate ( OR=2.92, 95% CI 1.74-4.88, P<0.001), proteinuria decreasing level ( SMD=0.35, 95% CI 0.09-0.61, P=0.008), the increasing level of serum albumin ( SMD=1.27, 95% CI 0.43-2.11, P=0.003) and the increasing level of estimated glomerular filtration rate ( SMD=0.48, 95% CI 0.21-0.76, P=0.001), lower relapse rate ( OR=0.19, 95% CI 0.05-0.72, P=0.015) as well as death rate ( OR=0.19, 95% CI 0.04-0.78, P=0.021)than those of the control group. Conclusion:The immunosuppressor could enhance complete remission rate, total remission rate, proteinuria decreasing level, the increasing level of serum albumin and the increasing level of estimated glomerular filtration rate, reduce relapse rate and death rate of HSPN patients.

Objective To explore the application effect of healthcare failure mode and effect a-nalysis(HFMEA)in nursing risk management of emergency surgery for patients with traumatic brain injury(TBI).Methods Taking the HFMEA model as the theoretical framework,the emergency sur-gical process of TBI was analyzed,a flow chart was drawn,and the potential risk factors were ana-lyzed.Corresponding intervention programs were adopted for high-risk failure modes,and 80 patients from November 2022 to April 2023 were conducted with routine management before implementation of HFMEA(control group),the other 80 patients from May to October 2023 were conducted with man-agement after implementation of HFMEA(observation group).The surgical efficiency(preoperative waiting time,surgical preparation time,anesthesia induction time,postoperative handover time),the incidence rates of adverse events in the operation room(incomplete preparation of supplies,contami-nation of surgical drapes,insufficient or defective intraoperative instruments,errors in writing nursing records,incorrect or missing items in handover information),the incidence rates of perioperative com-plications(low intraoperative body temperature,pressure injury,abnormal fluctuations in vital signs during surgery,wound infection,lung infection)and satisfaction degree of surgical doctors to nurses for current operations(itinerant nurses,instrument nurses)were compared between two groups.Re-sults The observation group had significantly shorter preoperative waiting time,surgical preparation time,anesthesia induction time,and postoperative handover time compared to the control group(P＜0.01).The incidence rate of adverse events in the operation room for the observation group was 16.25％,which was significantly lower than 46.25％of the control group(P＜0.01).The inci-dence rate of complications was 8.75％in the observation group,which was significantly lower than 26.25％in the control group(P＜0.01).Satisfaction degree of the doctors to nurses for the current operation in the observation group was significantly higher than that in the control group(P＜0.05).Conclusion Application of the HFMEA model in the perioperative nursing management of patients with emergency surgery for TBI can effectively improve surgical efficiency,reduce the inci-dence rates of nursing-related adverse events and complications,and enhance satisfaction degree of doctors to nurses in operation room.

Objective To explore the application effect of healthcare failure mode and effect a-nalysis(HFMEA)in nursing risk management of emergency surgery for patients with traumatic brain injury(TBI).Methods Taking the HFMEA model as the theoretical framework,the emergency sur-gical process of TBI was analyzed,a flow chart was drawn,and the potential risk factors were ana-lyzed.Corresponding intervention programs were adopted for high-risk failure modes,and 80 patients from November 2022 to April 2023 were conducted with routine management before implementation of HFMEA(control group),the other 80 patients from May to October 2023 were conducted with man-agement after implementation of HFMEA(observation group).The surgical efficiency(preoperative waiting time,surgical preparation time,anesthesia induction time,postoperative handover time),the incidence rates of adverse events in the operation room(incomplete preparation of supplies,contami-nation of surgical drapes,insufficient or defective intraoperative instruments,errors in writing nursing records,incorrect or missing items in handover information),the incidence rates of perioperative com-plications(low intraoperative body temperature,pressure injury,abnormal fluctuations in vital signs during surgery,wound infection,lung infection)and satisfaction degree of surgical doctors to nurses for current operations(itinerant nurses,instrument nurses)were compared between two groups.Re-sults The observation group had significantly shorter preoperative waiting time,surgical preparation time,anesthesia induction time,and postoperative handover time compared to the control group(P＜0.01).The incidence rate of adverse events in the operation room for the observation group was 16.25％,which was significantly lower than 46.25％of the control group(P＜0.01).The inci-dence rate of complications was 8.75％in the observation group,which was significantly lower than 26.25％in the control group(P＜0.01).Satisfaction degree of the doctors to nurses for the current operation in the observation group was significantly higher than that in the control group(P＜0.05).Conclusion Application of the HFMEA model in the perioperative nursing management of patients with emergency surgery for TBI can effectively improve surgical efficiency,reduce the inci-dence rates of nursing-related adverse events and complications,and enhance satisfaction degree of doctors to nurses in operation room.

Objective To evaluate the role of distortion product otoacoustic emissions (DPOAE) testing in evaluating early hearing loss among noise-exposed workers. Methods A total of 174 noise-exposed workers in a metal shipbuilding enterprise were selected as the research subjects by the convenience sampling method. Pure tone audiometry (PTA), DPOAE and the level of noise exposure were conducted on the workers. The rank correlation analysis was used to analyze the correlation between DPOAE amplitude and PTA threshold. The multilevel model was used to analyze the effects of gender, age, noise exposure intensity, cumulative noise exposure (CNE), hearing loss classification and PTA threshold on DPOAE results. Results At the frequencies of 0.50, 1.00, 2.00, 3.00, 4.00, 6.00 and 8.00 kHz, the DPOAE amplitude was negatively correlated with the PTA threshold (rank correlation coefficients were -0.12, -0.48, -0.47, -0.18, -0.23, -0.44, -0.19, respectively, all P<0.01). At the most frequencies, DPOAE amplitude was negatively correlated with age and CNE (all P<0.05). The results of multilevel model analysis showed that there were significant differences in DPOAE amplitudes at certain frequencies across gender, age, noise intensity, CNE, and hearing loss classification (all P<0.05). Significant differences in DPOAE responses were found among different CNE and hearing loss groups (all P<0.01). Conclusion DPOAE testing can objectively reflect the hearing status of noise-exposed workers and could be considered for inclusion in routine hearing monitoring to facilitate early detection of noise-induced hearing loss.

Objective To explore the relationship between exposure to air pollutants and chronic kidney disease. Methods We searched and screened the literature on air pollutant exposure and CKD, using Pubmed, Medline, Embase, and Cochrane databases from inception to May 1, 2020. Chronic exposure to air pollutants and risk of chronic kidney disease were estimated. Results Air pollutants can cause kidney damage to varying degrees, and PM_2.5 and PM₁₀ can increase the risk of chronic kidney disease. CO, NO₂(NO_X) and SO₂ may increase the risk of chronic kidney disease. Conclusions Exposure to air pollutants, especially particulate matter( PM_2.5 and PM₁₀) ，is associated with an increased risk of chronic kidney disease.

The clinical application of immune checkpoint inhibitors (ICIs) has significantly improved the prognosis of hepatocellular carcinoma (HCC) patients. With the widespread applica-tion of ICIs in HCC, the management of immune-related adverse events (irAE) gained more and more attention. However, the complicated disease characteristics and various combination therapies in HCC throw out challenges to irAE management. Therefore, the editorial board of the 'Chinese expert consensus on the management of immune-related adverse events of hepatocellular carcinoma treated with immune checkpoint inhibitors (2021 edition)' organizes multidisciplinary experts to discuss and formulate this consensus. The consensus focuses on issues related to HCC irAE manage-ment, and puts forward suggestions, in order to improve standardized and safety clinical medication, so as to maximize the benefits of immunotherapy for patients.