Objective:To prepare a bone substitute using microsphere scaffold containing adiponectin(APN)and to investigate the release behavior of the scaffold in vitro.Methods:Chitosan microsphere was developed by an emulsion-ionic cross-linking method. Poly (L-lactic-co-glycolic)acid (PLGA)and β-tricalcium phosphate (β-TCP)were used to prepare microsphere scaffold containing APN.The morphology,particle size,drug loading,incorporation efficiency and release behavior of the microsphere were examined. Results:The APN containing microsphere showed good spherical geometry,suitable size and microporosity under scanning electron microscope.The average diameter of the milipore was 20 -200 μm;the drug loading and incorporation efficiency were 1 .3% and 70.3% respectively.The controled-release process continued for 91 days.The extract solution from the APN microsphere-scaffold promoted MC3T3 cell proliferation without cytotoxicity.Conclusion:The APN microsphere-scaffold has sustained release function and may promote osteoblast proliferation.

Objective To explore the effects and safety of bevacizumab monotherapy on radiationinduced brain necrosis in patients with head and neck cancer.Methods Twenty-three patients with radiation-induced brain necrosis received intravenous injection of bevacizumab 5 mg/kg every 2 weeks for 4 cycles.Before and 2 weeks after the treatment LENT/SOMA scoring system,Montreal Cognitive Assessment (MoCA),and MRI were used to evaluate the scores of subjective and objective items,cognitive scores,and the extent of edema.Adverse effects were observed.Results Two patients suffered from grade 2 rhinorrhagia after the first dose and had to give up the therapy.Twenty-one patients received the full dose of bevacizumab and showed improvement in clinical signs and symptoms.The MoCA score after treatment was significantly higher than that before treatment (t =3.166,P ＜ 0.05).MRI T2-weighted image showed that the volume of brain edema was decreased by (53.9 ± 22.13)％ on average (Z =-5.645,P ＜0.05).One patient showed mild exacerbation of the extent of focus on MRI after the second cycle therapy but still showed significant improvement at the end of four cycles.Of the 21 cases that successfully finished the whole treatment,one suffered from grade 2 rash and one had mild intracranial hemorrhage,however,no grade 3 to 5 adverse reactions were observed.Conclusions Bevacizumab monotherapy may have a rapid and safe therapeutic effect on radiation necrosis.

Objective:To explore the clinical measurements for preventing and curing epistaxis in patients irradiated for nasopharyngeal carcinoma by analyzing the related factors. Methods:Thirty patients irradiated for nasopharyngeal carcinoma and consequently presented epistaxis were retrospectively reviewed by analyzing the clinical characteristics and measurements. Literature review was also performed. Results:Twenty-two cases were successfully rescued, and eight cases died (mortality rate:26.6%). Twenty-five cases underwent inflation sponge packing hemostasis, whereas three cases underwent endoscopic hemostasis with cauterization. Five patients underwent digital subtraction angiography (DSA) and selective arterial embolization. For patients who underwent one irradiation course, the epistaxis latent period ranged from 3 to 12 years, and the amount of bleeding ranged from 200 mL to 1 200 mL. For patients who underwent more than one irradiation course, the epistaxis latent period ranged from 6 months to 3 years, and the amount of bleeding ranged from 300 mL to 8 000 mL. Conclusion:Packing through choanal atresia by using inflation sponge, cautery under endoscopy, DSA, and selective arterial embolization are useful and effective measurements for hemostasis. The epistaxis latent period and volume are related to the age, tumor stage, and ir-radiation course of the patients. Patients with advanced age, tumor stage, and more than one irradiation course have short latent period and high amount of bleeding.

Objective:To explore the relationship between atrial fibrillation stroke risk score (CHA2DS2-VASc score) and short-term prognosis of aged patients with nonvalvular atrial fibrillation (NVAF)complicated ischemic cerebral stroke (ICS).Methods:A total of 206 aged NVAF+ ICS patients who hospitalized in our hosipital from Jun 2011 to Aug 2013 were selected.CHA2DS2-VASc score was used to perform stroke risk stratification,and patients were di- vided into low risk group (n=24,0 score),medium risk group (n=78,1 score)and high risk group (n=104,2~9 scores).Modified Rankin scale (mRS)was used to assess patients'prognosis on three months after onset.According to mRS score,patients were divided into good prognosis group (n=89,0~2 scores)and poor prognosis group (n=117,3~6 scores).Independent predictors for poor prognosis in three months were analyzed.Results:Compared with low risk group,there were significant rise in age,percentages of hypertension,diabetes mellitus (DM),heart failure,stroke and vascular disease history,scores of United States national institutes of health stroke score (NIHSS) in medium and high risk groups (P<0.05 or <0.01).Compared with good prognosis group,there were significant rise in age [(72.81±7.68)years vs.(81.56±8.03)years],percentages of hypertension (58.4% vs.71.8%)and stroke history (9.0% vs.29.9%),scores of NIHSS [(2.97±1.42)scores vs.(7.67±3.92)scores]and CHA2DS2- VASc [(1.70±1.63)scores vs.(4.03±2.53)scores]in poor prognosis group,P<0.05 or <0.01. Multi-factor Logistic regression analysis indicated NIHSS score (high risk:OR=1.78,95%CI:1.27~2.56,P=0.001 ), CHA2DS2-VASc scores (high risk:OR=3.24,95%CI:1.32~6.98,P=0.001)and age (high risk:OR=1.23, 95%CI:1.07~1.54,P=0.01)were independent predictors for poor prognosis on three months in aged NVAF +ICS patients.Conclusion:CHA2DS2-VASc score is related to early improvement of patients with NVAF + ICS;age,scores of NIHSS and CHA2DS2-VASc are independent predictors for poor short-term prognosis.

Objective:To evaluate the clinical value of the holographic image and navigation in robotic assisted laparoscopic radical prostatectomy (RARP) .Methods:From Sept. 2020 to Dec. 2020, 5 patients diagnosed with prostate cancer in Beijing United Family Hospital were included in this study. The mean age was 57 years(38-69 years). Before the operation, the engineers established the holographic image based on the enhanced MRI images. The holographic images were used in pre-surgery planning. During the operation, the navigation was achieved by real time fusing holographic images with the robotic surgery endoscopic views. Some important structure such as prostate, bladder neck and the tumor could be observed and monitored in real time. The No.1 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection; The No.2 patient had low-risk prostate cancer, underwent RARP, and the right side neurovascular bundle (NVB) was preserved; The No.3 patient had low-risk prostate cancer, underwent RARP, and the bilateral side NVB was preserved; The No.4 patient had low-risk prostate cancer, underwent RARP, and the right side NVB was preserved; The No.5 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection, and the bilateral side NVB was preserved.Results:All the 5 cases surgeries were successful, no conversion to open surgery, the mean operation time was 161.7min (160-250min), the mean blood loss was 426.7 ml(60-1000 ml). The pathological results were pT 3bN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0 and pT 3aN 1 cM 0, respectively. There was no over Clavien Dindo Ⅱ perioperative complications. 4 patient achieved continence when catheter removal. The PSA level and erectile function were monitored in the follow up. Conclusions:Holographic image navigation might have clinical value in RARP.

Objective To investigate the effects of electrical stimulation on the expression of nerve growth factor (NGF) in adult rats with spinal cord injury. Methods 72 adult SD rats were randomly divided into 3 groups: damage control group, electrical stimulation group and normal group. The spinal cord incomplete injury model on T9 was made with Allen's method. The electrical stimulation group received electrical stimulation for 7 d. They were assessed with the Basso, Beattie & Bresnahan locomotor rating scale (BBB scale), and the expression of NGF were tested with immunohistochemistry and Western blot l d, 3 d, 5 d, 7 d after injury. Results The BBB score improved after spinal cord injury, and electrical stimulation group improved more than control group since the 5th day after injury (P<0.05). The expression of NGF increased in electrical stimulation and injury control group after injury (P<0.05). Conclusion Electrical stimulation after spinal cord injury induces expression of NGF that creates a favorable microenvironment for nerve regeneration.

The prevalence of elderly dementia patients in our country is high, the course is long and the cost is high, the visiting rate is low and it is difficult to cure. The implementation of humanistic care to them is the essen-tial demands of medical spirits, also is a necessary supplement to the poor medical treatment and can also give more psychological support to patients and their families. Therefore, it should establish a sound service system, strength-en health education and cultivate professional accompanying staff, in order to enhance the quality of life of elderly dementia patients and improve the living conditions.

OBJECTIVETo evaluate the effects of different treatments on the prognosis of patients with synchronous colorectal liver metastasis(CLM).

METHODSClinicopathological data of 121 patients with synchronous CLM in The First Affiliated Hospital of Xinjiang Medical University between January 2010 and December 2014 were retrospectively analyzed. According to the metastatic lesions, patients were divided into simple operation group(22 patients, receiving operation only), simple chemotherapy group(43 patients, receiving chemotherapy only), and combination group(56 patients, receiving chemotherapy based on operation). The prognosis of patients in three groups was investigated. Univariate and multivariate analyses were performed through the long-rank test and Cox model to evaluate the related factors affecting prognosis.

RESULTSThe median survival time was 10(3-39) months in simple operation group, 7(3-36) months in simple chemotherapy group, and 18 (4-66) months in combination group. The differences among groups were all statistically significant (all P<0.05). Extent of lymph node metastasis, number of liver metastatic lesion, size of liver metastatic lesion, resection edge extent of liver metastatic lesion, and treatment method were independent factors of synchronous CLM(all P<0.05).

CONCLUSIONCombination therapy of a variety of treatment can prolong the survival of patients with synchronous CLM.

Objective:To understand the current status and analyze the factors of demoralization of patients with chronic heart failure (CHF), providing references for targeted psychological interventions of nursing staff.Methods:Using the cross-sectional survey method, from August 2022 to January 2023, 282 CHF patients who were followed up in the Cardiovascular Department of the First Affiliated Hospital of Zhengzhou University were selected as the study subjects. They were investigated using the General Information Questionnaire, Demoralization Scale Revised Mandarin Version, Brief Illness Perception Questionnaire (BIPQ), Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and the factors influencing the demoralization of CHF patients were analyzed using univariate analysis and multiple linear regression.Results:Among 282 cases, male 172 cases, female 110 cases, aged (62.29±10.05) years old. The Demoralization Scale Revised Mandarin Version′s score of CHF patients was (30.30 ± 10.37) points; the score of BIPQ was (42.18 ± 13.94) points; the score of FoP-Q-SF was (35.41 ± 7.29)points, which were at high level. The results of multiple linear regression analysis showed that patient disease duration, disease stages, New York heart association cardiac function classification, the score of BIPQ, and the score of FoP-Q-SF were factors influencing the demoralization of CHF patients ( t values were 3.08 to 12.50, all P<0.05). Conclusions:There is an urgent need to focus on the current status of the demoralization of CHF patients. It is necessary to develop a systematic and effective intervention strategy for demoralization, to take into account patient disease duration, disease stages, illness perception, and fear of progression in a comprehensive manner.

Objective:To analyze identification of copper death gene related subtypes,construction of prognosis model and influence of immune infiltration in osteosarcoma(OS)on basis of copper death gene.Methods:Survival and prognosis of OS associated copper death gene were analyzed combining by TARGET and GEO database.OS was divided into different subtypes of copper death by consistent clustering method.SSGSEA was used to analyze difference of immune cells in classification of copper death.Setting P value= 0.05 and q value=0.05,GO and KEGG enrichment analysis were performed on differential genes of copper death typing.Prognosis model was constructed according to results of Lasso regression analysis and cross validation,risk assessment analysis and ROC curve were used to evaluate accuracy of model prediction.Combined with clinical characteristics,nomograms were constructed to predict survival time of patients,and risk differences were analyzed.Immune cell infiltration and tumor microenvironment analysis were performed on OS samples."pRRophetic"package in R software was used to analyze drug sensitivity of OS samples.Results:FDX1,GLS,DLAT and PDHB as high-risk genes for OS prognosis were identified.According to copper death classification of OS samples,OS could be divided into two types:CRGclusterA and CRGclusterB.CRGclusterA was associated with Th2 cells,and CRGclusterB was associated with Th1 cells.Most OS copper death genes were highly expressed in CRGclusterA.Immune cell infiltration analysis results showed that γδ T cells,resting mast cells and resting dendritic cells were positively correlated with risk score,while CD8 T cells were negatively correlated with risk score.Drug sensitivity analysis showed that OS showed higher sensitivity to Elesclomol and GW.441756.Conclusion:Two subtypes of CRGclusterA and CRGclusterB are identified in this study.Four high-risk prognostic genes FDX1,GLS,DLAT and PDHB are identified,providing new insights into prognostic evaluation and immunotherapy target candidates for OS.