ObjectiveTo evaluate the effect of multiple punctures on the quality of inactivated poliomyelitis vaccine made from Sabin strains(sIPV)in 5-dose vials.MethodsPre-puncture samples were sampled by opening the cover from 3batches of sIPV stored for about 24 months and balanced at room temperature at least 20 min;The same three batches of sIPV were punctured for the first to fifth needle on the 0,7,14,21 and 28 d respectively,which were balanced at room temperature at least 20 min before each sampling. After sampling,the remaining samples were returned to 2～8 ℃ for preservation. According to the requirements of enterprise registration standard(YBS01052021),all the samples before and after the fifth needle puncture were tested,and the other 4 needle puncture samples were tested for pH,osmotic molar concentration,aseptic test,bacterial endotoxin,D antigen content of typeⅠ,Ⅱ and Ⅲ virus,appearance,abnormal toxicity,protein content and 2-phenoxyethanol content. The relative change rates of 2-phenoxyethanol content,protein content,osmotic molar concentration and D antigen content of typeⅠ,Ⅱ and Ⅲ virus were calculated. SPSS 20 software was used to analyze the relative change rate of each index by one-way ANOVA,and the effect of multiple punctures on the quality of sIPV was evaluated.ResultsThe result of each test item was in compliance with enterprise registration standard before and after each puncture. There was no significant difference between each puncture on the relative rate of change of 2-phenoxyethanol content,protein content,D-antigen content of typeⅡ and Ⅲ virus(F = 2. 125,1. 155,1. 137 and 1. 882,P = 0. 152,0. 386,0. 393and 0. 190,respectively);There was a significant difference in the relative change rate of osmotic molar concentration and Dantigen content of TypeⅠvirus(F = 4. 750 and 4. 010,P = 0. 021 and 0. 034,respectively). The result of Duncan test showed that compared with the first puncture,the relative change rate of osmotic molar concentration after the second and third puncture showed no significant difference,while that after the fourth puncture showed significant difference and a relatively stable result was observed after the fifth puncture. Regarding the relative rate of change of D-antigen content of TypeⅠvirus,there was no significant difference among the first,second,fourth and fifth punctures,while a significant difference existed between the third and the other four punctures.ConclusionFive punctures within 28 days had no effect on the quality of sIPV in 5-dose vials.

Clinical data of 23 patients with T2a bladder cancer admitted from March 2008 to August 2013 were retrospectively analyzed.Among 23 patients,11 cases were treated with transurethral resection (TURBT) plus arterial catheterization chemotherapy (study group) and 12 cases were treated with radical cystectomy (control group).The overall survival time and recurrence free survival time of two groups were compared.Patients in study group were followed up for 20-68 months,recurrence occurred in 5 cases (5/11),including 4 cases of invasive recurrence;patients in control group were followed up for 2 ～86 months,1 case had superficial recurrent and underwent TURBT,2 cases dead due to bladder tumor.During the course of chemotherapy,the main adverse effects were digestive reaction (7/11),fever (4/11),bone marrow suppression (2/11),symptomatic treatment was given,which was tolerated.There were no significant differences in overall survival time and recurrence free survival time between two groups (P ＞ 0.05).The quality of life of study group was better than that of control group (P ＜ 0.05).It is suggested that the arterial interventional chemotherapy combined with transurethral resection for T2a stage invasive bladder cancer has a certain curative effect with the advantage of preservation of bladder function and higher quality of life.

OBJECTIVE To investigate the expression of PTEN and VEGF gene in laryngeal squamous cell carcinoma and their clinical significance. METHODS The expression of PTEN and VEGF gene were examined by using immunohistochemical S-P staining method in 10 cases of normal tissues, 20 cases of para-tumor tissues and 60 cases of LSCC. RESULTS The positive rates of PTEN in normal tissues, para-tumor tissues and LSCC were 100.0 %, 95.0 %, and 70.0 % respectively (P＜0.05),and VEGF protein showed positive expression of 20.0 %,50.0 %,73.3% in normal, para-tumor and LSCC tissues with statistical significance(P＜0.05), In LSCC, the expression of PTEN and VEGF was positively correlated with TNM stage, differentiation of tumor, cervical and distant metastasis of lymph node, 3-year survive rate of patients(P＜0.05),No significant association was observed in expression of PTEN and VEGF with tumor location,patient's age and sex(P＞0.05). Spearman correlation analysis revealed that PTEN was negatively correlated with VEGF expression(?=-0.3948, P=0.0018). CONCLUSION The aberrant expression of PTEN and VEGF may play a role in occurrence, progression and metastasis of LSCC.

Objective To observe the prevention effect of glutathione on acute radiation enteritis in pelvic radiation therapy.Methods All 80 pelvic tumor patients treated with radiotherapy were randomly assigned to the control group (40 patients)and the treatment group (40 patients)by the number table method.40 cases in the con-trol group treated with radiation were not treated with preventive drugs,but the patients in the treatment group were treated with glutathione.The occurrence time of acute radiation enteritis and the severity of acute radiation enteritis after treatment were evaluated.Results 15.0% of the treatment group suffered from acute radiation enteritis in the second week and 72.5% in the third week.however,62.5% of the control group were suffered from acute radiation enteritis in the second week and 27.5% in the third week.The difference was statistically significant (χ2 =18.775, 15.998,all P <0.001).Glutathione delayed the occurrence time of acute radiation enteritis.The grade 1 and grade 2 acute radiation enteritis effective rate in the treatment group were 77.5% and 17.5%,and that in the control group were 20.0% and 72.5%,the difference between the two groups was significant(χ2 =26.136,24.139,all P <0.001).The glutathione could reduce the incidence of acute radiation enteritis extent.Conclusion Glutathione could delay the occurrence time of acute radiation enteritis and reduce the incidence of acute radiation enteritis extent.It is worth clinical application.

Objective To study the value of electronic administration analysis system used for pre-hospitalrecords in comparison with statistic data processed manually. Method The data of 'first aid medical records'collected from June 26, 2007 to December 26, 2007 in Wuxi Emergency Center, Wuxi, China were taken for anal-ysis. The items for comparison included the average number of emergency patients monthly, percentage of intra-venous infusion, proportion of ECG and blood oxygen saturation monitoring, rate of blood glucose measurement,number of pre-hospital treatment, frequency of using medical devices and time taken for answer to inquires. Thecomparison was carried out between statistic data processed manually and those processed electronically. ResultsBetween two different methods of statistic process, there were no significant in all items ( P > 0.05) except theshorter time required for electronic process to answer the inquires (P<0.01). Conclusions The electronic ad-ministration analysis system for the records of emergency patients is fully developed to meet the expectation in termsof quick answer to inquries with credibly and precisely numerical values.

Objective:To investigate the risk factors of cardiovascular and cerebrovascular events in patients undergoing maintenance hemodialysis (MHD).Methods:A total of 285 patients undergoing MHD in the Blood Purification Center of Yixing People′s Hospital from May 2013 to March 2018 were enrolled, including 137 patients with cardiovascular and cerebrovascular events and 148 patients without cardiovascular and cerebrovascular events. The demographic and clinical data of patients were retrospectively reviewed. The age, systolic blood pressure, duration of dialysis and prevalence of atherosclerosis were compared between the two groups; the risk factors of cardiovascular and cerebrovascular events were analyzed by multivariate logistic regression.Results:There were significant differences in age, systolic blood pressure, duration of dialysis and prevalence of atherosclerosis; serum creatinine, serum phosphorus, hs-CRP and triglyceride levels between the two groups ( P<0.05). Multivariate logistics analysis showed that age ≥50 years ( B=0.42, 95 %CI 1.06-3.06, P=0.03), duration of dialysis≥24 months ( B=0.85, 95 %CI: 1.23-3.79, P=0.01), atherosclerosis ( B=0.58, 95 %CI: 1.13-4.02, P=0.04), hypertension ( B=0.23, 95 %CI: 1.34-9.25, P<0.01), diabetic kidney disease (DKD) ( B=0.36, 95 %CI:1.19-8.27, P<0.01) , increased hs-CRP ( B=0.83, 95 %CI: 1.12-3.90, P<0.01), high serum phosphorus ( B=0.91, 95 %CI: 1.06-1.54, P<0.01) and elevated TG ( B=0.50, 95 %CI: 1.08-5.57, P<0.01) were independent risk factors for cardiovascular and cerebrovascular events in MHD patients. Early and active intervention of these risk factors may improve the clinical prognosis of MHD patients. The Cox survival curve showed that the probability of cardiovascular and cerebrovascular events increased when the duration of dialysis was>12 months, and it increased more significantly when the duratio n>24 months. Conclusion:The older age, dialysis duration, comorbidities of atherosclerosis, hypertension, DKD, and elevated serum hs-CRP, phosphorus, triglyceride may increase the probability of cardiovascular and cerebrovascular events for MHD patients.

Objective:To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects of forefoot with the help of the three dimensional computerized tomography angiography(3D-CTA).Methods:From November 2013 to February 2018, 19 patients with anterior foot defects were treated in the Yidu Central Hospital of Weifang. There were 12 males and 7 females. The patients ranged from 16 to 45 years old, with an average age of 29.6 years. Preoperative 3D-CTA examination of the ipsilateral foot was performed to find out the blood vessels in the donor site, to determine the location, course, length of the superficial branch of the medial plantar toe artery and its relationship with the surrounding tissues, and to design the medial saphenous nerve nutrient vessel skin flap for retrograde repair of the skin and soft tissue defect at the front of the foot. Sensitive recovery were evaluated according to Swanson evaluation of clinical effect of peripheral nervous impairment.Results:Preoperative three-dimensional CT angiography showed that the superficial branches of the medial plantar toe artery were detected, and the perforating vessels during the operation were basically consistent according to the result of the examination. The 19 cases of forefeet skin detects were successfully reconstructed with the reverse saphenous nerve neurocutaneous flaps. All patients were followed up with the mean of 8 months. All flaps survived totally without diabrosis and swelling. The walking and weight-bearing were normal and the blood supply of foot were good. The functional recovery of foot and ankle was excellent in 8 cases, good in 10 cases and middle in 1 case. The sensory recovery of the forefoot: S4 5 feet, S3 10 feet, S2 4 feet; R4 3 feet, R3 9 feet, R2 7 feet.Conclusions:Preoperative 3D-CTA examination can confirm the anatomy of the superficial branch of the medial toe base artery in the donor site and guide the design of the medial saphenous nerve nutrient vessel flap for retrograde repair of skin and soft tissue defects of the distal foot. The blood supply is reliable, the wound is small and the effect is satisfactory.

BACKGROUND:The low catalytic activity and lack of targeting of commonly used metal ions have severely limited the clinical application of chemodynamic therapy in tumor treatment.On the other hand,although the composite nanoplatforms are endowed with tumor-targeting functions by surface functionalization,the lack of tumor microenvironment acidity also severely weakens the efficacy of chemodynamic therapy. OBJECTIVE:To prepare novel composite nanoplatforms and assess their feasibility to enhance the effects of chemodynamic therapy at the cellular level. METHODS:SLC-0111-loaded zeolite imidazole framework-8 doped with divalent iron ions(Fe2+)and divalent cobalt ions(Co2+)(Fe-Co/ZIF-8@SLC-0111)was synthesized by ion-exchange reaction and self-assembly,and loaded with hyaluronic acid(HA)by electrostatic adsorption,followed by obtaining the target nanoparticles Fe-Co/ZIF-8@SLC-0111-HA(abbreviated as FC-S).Meanwhile,nanoparticles Fe-Co/ZIF-8-HA(abbreviated as FC)without SLC-0111 were synthesized by the same method.The nanocomposite platform was tested for particle size,zeta potential,surface morphology,in vitro reactive oxygen species generation,and ability to consume glutathione.Human osteosarcoma cell MG-63 and mouse fibroblast cell L929 were used as experimental subjects.The cytotoxicity of FC-S was detected by CCK-8 assay.Human osteosarcoma cell MG-63 was used as the experimental object to detect the cell internalization of FC-S.In addition to H2O2,the effects of FC-S and FC on intracellular pH,carbonic anhydrase 9 protein expression,cell viability and apoptosis,intracellular reactive oxygen species and glutathione content,and mitochondrial membrane potential were investigated. RESULTS AND CONCLUSION:(1)The FC-S composite nanoplatform was successfully prepared with a well-defined rhombic dodecahedral structure,uniform size and good dispersion.Its particle size was about 323 nm;zeta potential was about-11.1 mV,and the nanoplatform had a certain reactive oxygen species generation capacity in vitro.(2)FC-S nanoplatforms accumulated intracellularly in a time-dependent manner and could successfully escape from lysosomes.When the mass concentration of FC-S was≤20 μg/mL,there was no obvious cytotoxicity to MG-63 cells and L929 cells,and 20 μg/mL FC-S was selected to act on MG-63 cells in subsequent experiments.(3)Compared with FC group,the protein expression of carbonic anhydrase 9 in MG-63 cells in FC-S group was decreased(P<0.01);the intracellular acidic environment was enhanced;the content of reactive oxygen species was increased(P<0.001);the mitochondrial damage was aggravated;the number of dead cells was increased,and the apoptosis rate was increased(P<0.001).(4)The results indicate that FC-S,as a novel composite nanoplatform,can effectively improve the weakly acidic microenvironment in tumor cells and enhance the level of intracellular reactive oxygen species production,thus enhancing the efficacy of chemodynamic therapy.

Objective:To investigate the effect of reverse saphenous nerve neurocutaneous flaps for skin defects of forefoot with the help of the three dimensional computerized tomography angiography(3D-CTA).Methods:From November 2013 to February 2018, 19 patients with anterior foot defects were treated in the Yidu Central Hospital of Weifang. There were 12 males and 7 females. The patients ranged from 16 to 45 years old, with an average age of 29.6 years. Preoperative 3D-CTA examination of the ipsilateral foot was performed to find out the blood vessels in the donor site, to determine the location, course, length of the superficial branch of the medial plantar toe artery and its relationship with the surrounding tissues, and to design the medial saphenous nerve nutrient vessel skin flap for retrograde repair of the skin and soft tissue defect at the front of the foot. Sensitive recovery were evaluated according to Swanson evaluation of clinical effect of peripheral nervous impairment.Results:Preoperative three-dimensional CT angiography showed that the superficial branches of the medial plantar toe artery were detected, and the perforating vessels during the operation were basically consistent according to the result of the examination. The 19 cases of forefeet skin detects were successfully reconstructed with the reverse saphenous nerve neurocutaneous flaps. All patients were followed up with the mean of 8 months. All flaps survived totally without diabrosis and swelling. The walking and weight-bearing were normal and the blood supply of foot were good. The functional recovery of foot and ankle was excellent in 8 cases, good in 10 cases and middle in 1 case. The sensory recovery of the forefoot: S4 5 feet, S3 10 feet, S2 4 feet; R4 3 feet, R3 9 feet, R2 7 feet.Conclusions:Preoperative 3D-CTA examination can confirm the anatomy of the superficial branch of the medial toe base artery in the donor site and guide the design of the medial saphenous nerve nutrient vessel flap for retrograde repair of skin and soft tissue defects of the distal foot. The blood supply is reliable, the wound is small and the effect is satisfactory.

Purpose: The prognosis of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) is extremely poor, and systemic therapy is currently the mainstream treatment. This study aimed to assess the efficacy and safety of lenvatinib combined with anti–programmed cell death-1 antibodies and transcatheter arterial chemoembolization (triple therapy) in patients with HCC and PVTT. Materials and Methods: This retrospective multicenter study included patients with HCC and PVTT who received triple therapy, were aged between 18 and 75 years, classified as Child-Pugh class A or B, and had at least one measurable lesion. The overall survival (OS), progression-free survival (PFS), objective response rates, and disease control rates were analyzed to assess efficacy. Treatment-related adverse events were analyzed to assess safety profiles. Results: During a median follow-up of 11.23 months (range, 3.07 to 34.37 months), the median OS was greater than 24 months, and median PFS was 12.53 months. The 2-year OS rate was 54.9%. The objective response rate and disease control rate were 69.8% (74/106) and 84.0% (89/106), respectively; 20.8% (22/106) of the patients experienced grade 3/4 treatment-related adverse events and no treatment-related deaths occurred. The conversion rate to liver resection was 31.1% (33/106), with manageable postoperative complications. The median OS was not reached in the surgery group, but was 19.08 months in the non-surgery group. The median PFS in the surgery and non-surgery groups were 20.50 and 9.00 months, respectively. Conclusion Triple therapy showed promising survival benefits and high response rates in patients with HCC and PVTT, with manageable adverse effects.