Objective To investigate the effects of 5-aminolaevulinic acid-photodynamic therapy (ALA-PDT) on precancerous changes and carcinoma of the skin in situ. Methods Fifteen patients with actinic keratosis, 3 patients with erythroplasia of Queyrat and 8 patients with Bowen′s disease were given topical ALA followed by PDT. Results The clearance was achieved in 17 lesions of 15 patients with actinic keratosis, 2 patients with erythroplasia of Queyrat and 7 patients with Bowen′s disease by topical ALA-PDT. The recurrence rates were 13.33%, 0 and 14.28% for actinic keratosis, erythroplasia of Queyrat and Bowen′s disease, respectively. Conclusions Topical ALA-PDT is a simple, effective and new treatment with lower recurrent rates, no scar formation and excellent cosmetic results for precancerous changes and carcinoma in situ of the skin, especially for the large and multifocal lesions located on the face and external genitalia.

Objective To investigate the efficacy observation of transcranial direct current stimulation (tDCS)for improving the attention in patients with infarction in basal ganglia area. Methods Sixty consecutive patients with basal ganglia infarction admitted to the Department of Rehabilitation Medicine,the First Affiliated Hospital of Nanchang University from May 2015 to May 2016 were enrolled. They were randomly divided into either a control group or a test group according to the random number table (n = 30 in each group). The patients in both groups received routine rehabilitation training,and those in the test group received tDCS therapy synchronously,and the control group received the sham tDCS stimulation. The evaluations and analyses were conducted with the Montreal cognitive assessment (MoCA),d2 test of attention,and event-related potential-P300 (ERP-P300),respectively in all patients before intervention and 4 weeks after intervention,and they were compared between the groups. Results There was no significant difference before intervention between the two groups (all P > 0. 05). Compared with before intervention,the ERP-P300 latencies were reduced,the amplitudes were increased after intervention in the patients of the test group and the control group (all P < 0. 05). The MoCA total scores (the test group:22. 7 ± 2. 7 vs. 15. 5 ±
2. 4;the control group:17. 2 ±2. 5 vs. 15. 6 ±2. 3),attention dimension scores (the test group:4. 6 ± 1. 2 vs. 2. 4 ± 1. 6;the control group:3. 6 ± 1. 5 vs. 2. 5 ± 1. 5),and the total completion of d2 attention test task, total scores,and concentration degree scores (the test group:295 ± 31 vs. 250 ± 45,279 ± 38 vs. 223 ± 52, 97 ± 22 vs. 75 ± 25;the control group:276 ± 33 vs. 247 ± 45,257 ± 39 vs. 211 ± 56,84 ± 23 vs. 71 ± 24) were all increased (all P < 0. 05),and all the indexes of the test group were better than those of the control group (all P < 0. 05). Conclusion tDCS contributes to the improvement of the attention in patients with infarction in the internal capsule-basal ganglia region.

Objective To investigate the clinical efficacy and safety of high-frequency electric snare for the treatment of main airway neoplasm through bronchoscopy. Methods The clinical datas of 18 patients from July 2013 to April 2016, who had main airway neoplasm and were treated with high-frequency electric snare through bronchoscopy, were retrospectively analyzed. Meanwhile, the interventional bronchoscopic techniques partly included argon plasma coagulation and cryoablation. After operarion, the relief of symptoms and complications were observed. Results After operarion, the clinical symptoms, shortness of breath, dyspnea index score and the degree of airway stenosis were improved significantly. No serious complications such as massive hemoptysis occurred in all patients. Conclusion High-frequency electric snare is an effective and safe approach for the treatment of main airway neoplasm.

Objective:To compare the clinical effect of anterior and posterior resection,bone grafting and internal fixation on the spinal tuberculosis.Methods:82 cases of patients with spinal tuberculosis in our hospital from February 2014 to August 2015 were selected and randomly divided into the control group and the observation group with 41 cases in each group.Both groups received conventional anti tuberculosis treament and underwent debridement bone graft and internal fixation treatment,the control group underwent anterior internal fixation,while the observation group underwent posterior internal fixation.The operation time,intraoperative blood loss,low back pain relief time,ambulation time and hospitalization time were compared between two groups.All patients were followed up for 6 months,the Frankel grade and serum Thl7 cell related factors levels were compared between two groups before and after operation.Results:The low back pain relief time,ambulation time and hospitalization time of observation group were significantly shorter than those of the control group(P＜0.01).After operation,the Frankel classification grade A and B ratio of observation group were significantly higher than those of the control group (P＜0.05),the serum IL-10,IL-17,IL-23 and TGF-beta 1 levels were significantly lower than those of the control group (P＜0.01).Conclusion:Anterior resection combined with posterior bone graft inFixation could effectively promote the rehabilitation of spinal tuberculosis,reduce the severity of spinal injury,relieve the inflammatory response and promote the recovery of immune function.

Objective:To evaluate the inflammatory factors effects of early endoscopic therapy for elderly patients with acute biliary pancreatitis (ABP) and its clinical efficacys.Methods:206 elderly patients with ABP admitted from Jan. 2010 to Dec. 2019 were divided into observation group (102 cases) and the control group (104 cases) according to treatment method. The observation group received endoscopic retrograde cholangiopancreatography (ERCP) , endoscopic sphincterotomy (EST) and endoscopic naso-biliary drainage (ENBD) , while the control group received conventional treatment. Clinical symptoms, changes of inflammatory factors, complications and prognosis were observed in each group.Results:CRP, SAA, IL-6, IL-8 and TNF-a after treatment were significantly lowered than those before treatment ( P<0.05) . In addition, the levels of CRP, SAA, IL-6, IL-8 and TNF-a in the observation group were significantly lower than those in the control group ( P<0.05) . The time to abdominal pain extinction, time to fever cessation, hospital stay in observation group were (3.92±1.54) , (3.63±1.41) , and (14.35±2.46) d, significantly less than those in the control group [ (5.81±1.72) , (5.45±2.13) , (19.37±3.12) d, P<0.05]. APACHE Ⅱ score of the observation group was (10.02±2.67) point after treatment, significantly lower than that in the control group [ (12.35±3.62) point, t=4.42, P<0.05]. The incidence of complications in the observation group was 10.78% after treatment, significantly lower than that in the control group [ (24.03%) , χ2=6.27, P< 0.05]. The mortality in the observation group was 1.96%, lower than 4.81% in the control group, with no statistical significance. Conclusion:Early endoscopic therapy is safe and highly effective for elderly patients with ABP, with the advantages of shorter hospital stay, quicker subsided inflammation, and lower incidence of complications.

Objective To evaluate the efficacy and safety of single flexible ureteroscope vs.flexible ureteroscope combined with intraoperative ultrasonography guided in the endogenous renal cyst incision and drainage.Methods Retrospective analysis of case data of 64 patients with endogenous renal cysts admitted from January 2015 to December 2017.All the patients undrwent contrast-enhanced CT,urinary tract imaging,ultrasound B to confirm bosniak classification Ⅰ and Ⅱ renal cyst.The patients (38 males,26 females) were divided into single flexible ureteroscope group [group A,32 cases of patients,average age (54.2 ±6.6) years,unilateral or bilateral cystic patients:19 cases/ 13cases,simple cyst of kidney or polycystic kidney:24 cases/8 cases,average maximum diameter of the renal cyst (5.4 ± 1.3) cm,combined with renal calculus:8 cases,combined with hydronephrosis:7 cases,1 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture] and flexible ureteroscope group combined with intraoperative ultrasonography guided [group B,32 cases of patients,average age (52.3 ± 9.3) years,unilateral or bilateral cystic patients:21 cases/11 cases,simple cyst of kidney or polycystic kidney:25 cases/7 cases.Average maximum diameter of the renal cyst (5.3 ±1.2) cm,combined with renal calculus:9 cases,combined with hydronephrosis:8 cases,2 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture].The double J stent was placed two weeks before the surgery into the body of patients.During the operation,the surgical procedure were used by the electronic flexible ureteroscope and holmium laser (0.8 J,20 Hz),combined with ultrasound B in the monitoring,to find the suitable incision position.It would be defined as the successful result if we could put the head of flexible ureteroscope into the inside of renal cyst and see the image of mist in the screen of ultrasound B.According to the standard,the result of operation wound be defined compared to before operation (success:shrink more than 80％ or maximum diameter was smaller than 1 cm;improvement:shrink about 50％-79％;ordinary result:shrink about 30％-49％;failure:shrink smaller than 30％).Effective rate =(success cases + improvement cases)/total cases.We compared the differences of two groups in the time,efficacy,safety and complication of surgery.Results Compared the results of single flexible ureteroscope groups vs flexible ureteroscope group combined with intraoperative ultrasonography guided in the success cases of surgery,after 8-30 months following-up,total operative complication rate was [8 cases(25％)vs.1 case(3.1％)],success rate of operation in 6 month later [(20 cases (62.5％) vs.28 cases (87.5％)].Flexible ureteroscope group combined with intraoperative ultrasonography guided had advantages statistically (P ＜ 0.05).However,there was no statistical difference for the two groups in the time of operation [(33.4 ± 6.7) min vs.(35.1 ± 8.6) min],single operative complication (intraoperative wounding bleeding:3 cases vs.1 case,postoperative urinary infection:3 cases vs.0 case,perinephric space effusion:2 cases vs.0 case,renal function impairment:1 case vs.0 case)(P ＞0.05).Conclusions Flexible ureteroscope combined with intraoperative ultrasonography guided can help the urologist can improve the success rate of surgery and reduce the chance of surgical injury intraoperatively.

Objective:To assess impact of radiation from nuclear power on the surrounding environment, a dose assessment model was constructed and relevant dose coefficients were determined through refined animal models.Methods:Zebrafish is one of the most important aquatic model animals in the radiation hazard assessment of nuclear power liquid effluent. A geometric model of zebrafish containing internal bones and visceral organ was established for dose estimation. The internal and external dose coefficients (DC) of the zebrafish model were calculated by Monte Carlo method with seven nuclides as the source term, 3H, 40K, 58Co, 60Co, 110Ag, 134Cs, 137Cs, which are common in nuclear liquid effluents and environmental monitoring. Results:The level of nuclide gamma energy determines dose coefficients for external radiation. The dose coefficients of most nuclides in internal organs was higher than that in whole body, and the internal organ dose of 58Co was 165% higher than that in whole body. The internal radiation dose coefficients of the model established in this study was relatively high, and the internal radiation dose coefficients caused by 60Co was 2.6 times of existing ellipsoid model, which suggested that the different internal materials and the choice of different particle types would affect the energy deposition. Conclusions:Refining of model animals is important. Accurate assessment of the organs dose coefficients of model animals is helpful to assess the radiation effects on non-human species.