Objective:To explore the curative effect and adverse reactions of cisplatin combined with rIL-2 on malignant pleural effusion. Methods:Totally 60 cases of patients with malignant pleural effusion were randomly divided into the observation group ( 30 cases) and the control group (30 cases). In the observation group, 30 cases were given intrapleural injection of cisplatin and rIL-2 af-ter the pleural effusions were drained, and in the control group, the patients received intrapleural injection of cisplatin. Both of the two groups were observed of tumor response and drug adverse reactions, compared the quelity of life and immune function indicators before and after treatment. Results:The response rate in the observation group was 83. 3%, which was significantly higher than that in the control group (56. 7%) (P<0. 05). The improvement of Karnofsky score in the observation group was 86. 7%, which was also nota-bly higher than that in the control group(63. 3%) (P<0. 05). After the treatment, CD4 level and CD4/CD8 were significantly in-creased in the observation group(P<0. 05), while those in the control group were notably decreased (P<0. 05), and the difference was statistically significant (P<0. 05). The incidence of adverse reactions shew no significant difference between the two groups (P>0. 05). Conclusion:Cisplatin combined with rIL-2 shows confirmed effects in the patients with malignant pleural effusion.

Objective To explore the operative indication operation time and post-operative care for infants with large ventricular septal defects (VSD).Methods Eighty-eight infants who suffered from large VSD were selected,male 53 cases,female 35 cases,aged from 3 to 18 months[average (7.5-±2.9) months],weight from 5 to 13 kg [average (7.9 ± 1.9) kg].All patients underwent VSD repair and other accompanied anomaly corrections under cardiopulmonary bypass.Fifty-eight cases were operated through right atrium,14 cases through pulmonary artery and 16 cases through right ventricle.Patch repairs were done in all patients,78 cases given bovine pericardium patches,10 cases given self pericardium patches treated by Glutaral.Patients were sent to the intensive care unit after surgery,vasoactive drugs were used as a routine method.Antibotics were selected based on their sputum cultures postoperatively.Nutritional support was given in the earlier stage.Results There were no hospital death,average hospitalization days were (15.2 ± 5.9) days (from 11 to 32 days).The main complication were pneumonia (5 cases),bad coalesce of incision (4 cases),atelectasis (3 cases),minimal residual shunt of VSD (3 cases).All patients were discharged from hospital,76 cases were followed up from 1 to 12 months,2 cases had residual shunt of VSD,the residual shunt of the other case disappeared;76 patients had no clinical symptom,28 patients body weight returned to normal after 6 months of operation.There was no other complication and death.Conclusion Early surgical treatment for infants with large VSD is a safe and effective way with a better prognosis.

Objective To investigate the application of vascularized free fibula flaps in reconstruction of mandibular defect,and to evaluate the survival rate and repair effect of the method.Methods 16 patients with mandibular tumor,having a desire to reconstruct mandible,and their systemic state could tolerate the long time operation, were selected to reconstruct mandibular defect by vascularized fibula flaps,of which 12 were male,4 female,aged 24-66 years old,average 45.2 years old.The resection of primary tumor and free fibula flaps were simultaneously conducted,then the fibular flaps were shaped according to the defect location and size of the mandible,and were fixed with reconstructive titanium plate for repair and reconstruction of mandible. The survival of flaps was determined by skin color, texture, and skin temperature of the flaps. The reconstruction effects were evaluated through the patients’surface like photos and X-ray picture of mandible before and after operation.Results All of flaps were survived and no serious complications were found. The complications of the supplied sites were skin tension and wound dehiscence, which were healed by dressing. The mandibular reconstruction effects were good through 2 or more persons’double blind evaluation.Conclusion Free fibula flaps have high survival rate and good results in mandibular reconstruction,and they can meet the needs of various types of mandibular defect repair.

on,size and the extent structures of atrial septal defect on line.

Objective:To investigate the application of lateral upper arm free flap in the repair of postoperative soft tissue defects after operation in the patients with tongue cancer, and to evaluate its survival rate and repair effect. Methods:Ten patients with tongue cancer, having a desire to repair soft tissue defect after tongue cancer operation, and their systemic state could tolerate the long time operation, were selected to repair tongue cancer postoperative defects with lateral upper arm flaps. Among them, 7 cases were male, 3 cases were female;aged 45-67 years old, average 52.1 years old.Radical resection of tongue cancer was primarily finished, then the flaps were designed and prepared to repair the defects of tongue according to the location and size of defects.After the operation, the survival rate of the flap was observed, and the effect of repair was evaluated according to the shape, size, volume and movement of the tongue.Results:The lateral upper arm flaps were stable and simple to prepare, the donor sites were concealed, and the upper limbs were not abnormal.All of flaps survived, and all of wounds healed primarily.The shape, size, and texture of tongues were satisfied, and the movements of tongue were not significantly restricted.After repair, the voice, mastication and swallowing function of the patients were good without obvious influence.Conclusion:The survival rate of lateral flap of upper arm is high, and the tongue shape and function were good after tongue defect repair.It is an ideal free flap for repairing the tongue tissue defect of tongue cancer after operation.

Objective To investigate the status of self-management of elderly patients with chronic heart failure (CHF) in Xinjiang Region,and to explore the effects of different demographic factors on self-management.Methods A total of 704 patients with chronic heart failure were randomly selected from Urumqi,Kashgar,Khotan,Changji,Shihezi,Yili Hazakh in Xinjiang Uygur Autonomous Region via convenience sampling method and were investigated using heart failure self-management scale.Results The total score of self-management of chronic heart failure elderly patients was(47.6±11.1) and scoring rate was 59.5％.There were statistically significant differences(P＜0.01) in self-management score among patients with different ethnicity,religion,self-care ability,per capita income.The influencing factors of self-management were self-care ability,NYHA class and per capita monthly income(P＜0.05).Conclusion The overall level of self-management of elderly patients with chronic heart failure in Xinjiang Region is low,and self-management is affected by self-care ability,NYHA class and per capita monthly income.Tailored culture-based education should be provided to improve patients' self-management.

Objective: To establish the method of percutaneous endoscopic gastrostomy(PEC) and percutaneous endoscopic jejunostomy (PEJ) for enteral nutrition. Methodes: PEG tubes were placed in 114 patients with Pull method. On the foundation of PEG, PEJ tubes were placed in 26 patients by pushing endoscopy to send tubes through Treitz ligment with usingthe the clip. Results: All PEG insertion was performed successfully. PEJ tubes were placed successfully with a new method in 26 patients. 15 patients had a little blooding and 8 patients had slight infection. 21 patients had respiratory tract infection and had been cured by using antibiotic. There was no severe complication. Conclusion: PEG is simple、safe、efficient. The new method of PEJ is feasible.

Cytochrome P450 2A6(CYP2A6) is known as a major enzyme responsible for C-oxidation of nicotine and 7-hydroxylation of coumarin. The article reviews different alleles of CYP2A6 that have been discovered, their effect on CYP 2A6 activity and the relationship between genetic polymorphism of CYP2A6 and smoking behavior as well as susceptibility of lung and esophageal cancer in different individuals.
Aryl Hydrocarbon Hydroxylases ; genetics ; Cytochrome P-450 CYP2A6 ; Esophageal Neoplasms ; enzymology ; genetics ; Genetic Predisposition to Disease ; genetics ; Humans ; Lung Neoplasms ; enzymology ; genetics ; Mixed Function Oxygenases ; genetics ; Polymorphism, Genetic ; Research ; Smoking ; genetics

Objective To explore the influencing factors of proton and heavy ion therapy based on decision tree model for significant weight loss among patients with cancer so as to provide research foundation for the implementation of preventive nutritional support. Methods The associated factors of critical weight loss were investigated among 375 cancer patients in Shanghai Proton and Heavy Ion Center from June 2015 to June 2016. Results The mean weight loss was 0.5 kg during proton or heavy ion therapy, with only 11% of the patients lost more than 5% of the weight. Results of univariate analysis indicated that age, tumor site, recurrence or not, concurrent chemotherapy, surgical history, radiotherapy modality, total dose and total fractions were significantly associated with critical weight loss. Results of decision tree showed total fraction was the principal discriminator, the next division was tumor site and radiotherapy modality, and surgical history was the last determinant of critical weight loss. Conclusions Total fractions, tumor site, radiotherapy modality and surgery history were significant factors of critical weight loss during proton and heavy ion therapy, which helps the healthcare staff identify the high risk cancer patients, and offer predictive nutrition support before radiotherapy.

Objective:To explore the mediating effect of self-management efficacy between social support and self-management behavior in cancer patients treated with proton-heavy ions.Methods:From April 2020 to April 2021, convenience sampling was used to select 674 cancer patients in Shanghai Proton and Heavy Ion Center as the research subject. The patients were investigated with the General Information Questionnaire, Chronic Disease Self-Management Study Measures (CDSMS) , Chinese-version Strategies Used by People to Promote Health (C-SUPPH) , and Medical Outcome Study Social Support Survey (MOS-SSS) . Statistical analysis was performed using SPSS 24.0 and AMOS 24.0 software. Pearson correlation was used to calculate the correlation between variables, and a structural equation model was constructed to test the relationship between variables. A total of 674 questionnaires were distributed, 610 valid questionnaires were recovered, and the valid recovery rate was 90.5% (610/674) .Results:The total scores of self-management behavior, self-management efficacy, and social support in 610 cancer patients treated with proton heavy ions were (18.38±7.64) , (94.30±22.72) and (73.97±13.94) , respectively. Pearson correlation analysis showed that except for the dimension of life support with dimension of exercise, all the other dimension scores and the total score of patients' social support were positively correlated with all the dimension scores and the total score of self-management behaviors ( P<0.05) ; the dimension scores and the total score of patients' social support were positively correlated with the dimension scores and the total score of self-management efficacy ( P<0.05) ; the dimension scores and the total score of patients' self-management efficacy were positively correlated with the dimension scores and the total score of self-management behavior ( P<0.05) . Self-management efficacy had a partial mediating effect between social support and medical staff communication behavior, with an effect value of 23.4% ( P<0.05) . Conclusions:Cancer patients treated with proton-heavy ions have poor levels of self-management behavior. Nurses can improve the patients' self-efficacy and enhance the impact of social support on the patients' self-management behavior, so as to promote the precise realization and timely completion of proton heavy ion therapy.