Objective: To investigate the compatible stability of ceftazidime and ormidazole chloride sodium injection with sequential intravenous dripping.Methods: The contents and the absorption curves of ceftazidime and ormidazole sodium chloride injection in the mixture were determined by UV.The appearance of the solution was observed and the pH value was determined.Results: With the quality ratio of ceftazidime to ormidazole at 1∶25, 1∶50 and 1∶100, the mixture color changed from light yellow to light pink in 40, 45 and 48 min, respectively, and gradually deepened with the extension of time.With the quality ratio of ormidazole to ceftazidime mixture at 1∶400, 1∶800 and 1∶1 600, the color was stable in 3 h.There were no evident changes in the appearance, pH, content and absorption curves.Conclusion: The solution containing ormidazole and ceftazidime might have changes in color.Clinical pharmacist suggests that ormidazole chloride sodium injection be given intravenously, and then sequentially followed by ceftazidime.

Objective:To investigate the changes of directional connections of auditory and non-auditory in patients with noise-induced deafness (NID) by degree centrality (DC) and Granger causality analysis (GCA), and to explore the mode of brain function remodeling after NID.Methods:In October 2023, a total of 58 patients diagnosed with NID by the Occupational Diseases Department of Yantaishan Hospital of Yantai from 2014 to 2022 were collected as case group (NID group), and 42 healthy volunteers matched by gender, age and education level were selected as the control group (HC group). Resting state-functional magnetic resonance imaging (Rs-fMRI) was perfomed and PC analysis was performed. The brain regions with statistically significant differences in DC values between groups and the bilateral Heschl regions were extracted as regions of interest (ROI) for voxel-based whole brain GCA and correlation analysis.Results:Compared with HC group, the SOG.L DC value of NID group was lower, the connectivity values of SFGdor.L to SOG.L was increased, the connectivity value of PCL.L to SOG.L was decreased, the connectivity values of ORBmid.L, PCG.R and CUN. L/R to HES.L were increased, the connectivity value of SFGdor.L to HES.L was decreased, the connectivity value of HES.L to PCUN.L was decreased, the connectivity values of ORBsup.L and PCG.R to HES.R were increased, the connectivity value of HES.R to CUN.L was decreased ( P voxel level<0.01, P cluster level<0.05). The connectivity value of PCL.L to SOG.L was negatively correlated with the weighted value of the better whisper frequency ( P<0.05) . Conclusion:The NID patients have abnormal directional connectivity activity in multiple brain regions, such as auditory vision, executive control, somatosensory movement, and default mode network. It is suggested that hearing loss may cause complex neural remodeling between auditory and non-auditory centers.

Objective:To investigate the changes of directional connections of auditory and non-auditory in patients with noise-induced deafness (NID) by degree centrality (DC) and Granger causality analysis (GCA), and to explore the mode of brain function remodeling after NID.Methods:In October 2023, a total of 58 patients diagnosed with NID by the Occupational Diseases Department of Yantaishan Hospital of Yantai from 2014 to 2022 were collected as case group (NID group), and 42 healthy volunteers matched by gender, age and education level were selected as the control group (HC group). Resting state-functional magnetic resonance imaging (Rs-fMRI) was perfomed and PC analysis was performed. The brain regions with statistically significant differences in DC values between groups and the bilateral Heschl regions were extracted as regions of interest (ROI) for voxel-based whole brain GCA and correlation analysis.Results:Compared with HC group, the SOG.L DC value of NID group was lower, the connectivity values of SFGdor.L to SOG.L was increased, the connectivity value of PCL.L to SOG.L was decreased, the connectivity values of ORBmid.L, PCG.R and CUN. L/R to HES.L were increased, the connectivity value of SFGdor.L to HES.L was decreased, the connectivity value of HES.L to PCUN.L was decreased, the connectivity values of ORBsup.L and PCG.R to HES.R were increased, the connectivity value of HES.R to CUN.L was decreased ( P voxel level<0.01, P cluster level<0.05). The connectivity value of PCL.L to SOG.L was negatively correlated with the weighted value of the better whisper frequency ( P<0.05) . Conclusion:The NID patients have abnormal directional connectivity activity in multiple brain regions, such as auditory vision, executive control, somatosensory movement, and default mode network. It is suggested that hearing loss may cause complex neural remodeling between auditory and non-auditory centers.

Objective:To explore the independent risk factors of poor healing of surgical incisions in patients with drainage tube removal after thoracic and abdominal surgery and establish a risk prediction model for poor healing of surgical incisions.Methods:Using the convenient sampling method, a total of 545 patients who underwent thoracic and abdominal surgery in the Affiliated Hospital of Qingdao University were selected from July to December 2020. The patients were divided into the poor wound healing group ( n=87) and the non-incision poor healing group ( n=458) according to whether they had poor wound healing. Logistic regression analysis was used to analyze the risk factors of poor healing of surgical incisions and build a risk prediction model. The receiver operating characteristic (ROC) area under the curve was used to test the model to predict the effect and 230 patients were selected to verify the model prediction effect. Results:In this study, 5 factors including duration of exudation, serum albumin, incision infection, the volume of exudation during catheterization and catheterization time were finally included to construct a risk prediction model. The model formula was Z=4.608+4.855× duration of exudation +3.173× serum albumin +3.739× infection of the incision +2.271×the volume of exudation during catheterization + 0.466× catheterization time. The area under ROC curve of this model was 0.773 (95% CI: 0.678 - 0.868). The maximum value of Youden index was 0.549, the sensitivity was 0.742 and the specificity was 0.807. Conclusions:The risk prediction model of poor incision healing after drainage tube removal for patients undergoing thoracic and abdominal surgery can better predict the risk of poor incision healing and provide a basis for clinical medical staff to take preventive management measures for high-risk patients in time.

Madelung′s disease is a rare lipid metabolic disorder with unclear mechanism, characterized by the formation of diffuse uncapsulated lipomas in face, neck, shoulder and other body areas. This disease mainly affect middle-aged male, and is related to alcohol abuse. The treatment nowadays is only palliative surgery with a high recurrence rate, including lipectomy and liposuction. Both of them have advantages and disadvantages.

Objective To analyze the composition of the aqueous extract of Polygonatum Cyrtonema Hua(PCHE)and evaluate its antitumor activity in vitro and in vivo.Our aim is to provide a theoretical basis for the further development and utilization of Polygonatum Cyrtonema Hua.Methods(1)PCHE was prepared by aqueous extraction,and the chemical composition of PCHE was analyzed by UPLC-Q-TOF/MS and phenol-sulfuric acid method.The inhibitory activity on tumor cells proliferation of PCHE was detected by CCK-8 assay.Cell cycle and apoptosis were detected by flow cytometry,and the expression of apoptosis-related proteins Bcl-2 and Bax was detected by Western Blot.The inhibitory activity of PCHE-containing serum on cell proliferation was detected.(2)A B16 tumor-bearing mice model was constructed and model mice were randomly divided into the model group(saline),the positive drug group(CTX:50 mg·kg-1),and PCHE low-,medium-,and high-dose groups(55.9,111.8,223.6 mg·kg-1),and treated by gavage for 7 days.Changes in body weight and tumor volume of mice were observed during the treatment period.The mice were executed after the treatment,and the histopathological changes of heart,liver,spleen,lung,kidney and tumor were observed by hematoxylin-eosin(HE)staining.The protein expression of Bcl-2 and Bax in tumor tissues was detected by immunohistochemistry(IHC).Results The polysaccharide content of PCHE reached(10.07±1.3)%,and the flavonoid content was(0.044±0.004)%,and thirty-nine components were detected by UPLC-Q-TOF/MS,which contained antitumor components such as flavonoids(baicalein,quercetin,luteolin and rutin),organic acids(ferulic acid)and polyphenols(gallic acid),etc.PCHE exhibited the inhibitory effects on Hela,A549,4T1,B16,MFC and HepG2 cells,among which the inhibitory effect on B16 cells was the most significant(P＜0.001),and PCHE induced cell cycle arrest at G0/G1 phase in B16 cells(P＜0.001).The results of double-staining flow cytometry and Western Blot showed that PCHE significantly promoted apoptosis of B16 cells,decreased the expression of Bcl-2,and promoted the expression of Bax(P＜0.01,P＜0.001).and PCHE constituents absorbed into blood also had an inhibitory effect on B16 cells(P＜0.001).In addition,the results of in vivo activity assay showed that different doses of PCHE could inhibit tumor growth,induce tumor cell necrosis,reduce Bcl-2 expression,and increase Bax expression compared with the model group.Conclusion The ingredients in PCHE are abundant.It contains a variety of antitumor active ingredients,which can inhibit tumor growth,induce tumor cell apoptosis,show strong anti-tumor effects and be worthy of in-depth study.

Objective:To analyze the CT and MRI imaging features of Kimura disease in parotid region.Methods:This study was a cross-sectional study. From January 2018 to June 2023, a total of 40 patients with Kimura disease in parotid region who were initially diagnosed and confirmed by postoperative pathology were retrospectively collected in the Ninth People′s Hospital, School of Medicine, Shanghai Jiao Tong University. There were 36 male patients and 4 female patients, with an age of (46±19) years, ranging from 8 to 74 years old. The clinical data, preoperative CT and MRI findings were analyzed. For patients undergoing MRI examination, the apparent diffusion coefficient (ADC) value of the lesion was measured, and the type of time-signal intensity curve (TIC) was analyzed.Results:The ratio of male to female patients was 9∶1, with a long clinical history (1 month to 20 years). And 37 cases (37/40, 92.5%) were associated with elevated peripheral blood eosinophils. Among the 40 cases, there were 4 cases of nodular type, 34 cases of diffuse type, and 2 cases of intermediate type. Nodular type: All lesions were located in the superficial lobe of unilateral parotid gland, and 3 cases had multiple lesions. The lesions were round, well-defined, and homogeneous in density or signal intensity. Two lesions showed hyperintensity on T 2WI and obvious homogeneous enhancement. The TIC was plateau type, and the ADC values were 0.74×10 -3 mm 2/s and 0.82×10 -3 mm 2/s. Diffuse type: The 22 cases had multiple lesions, and 20 cases had subcutaneous lesions in other parts of the head and neck. The lesions were irregular in shape and ill-defined in boundary. The adjacent subcutaneous tissue and skin were involved in 33 cases. The density or signal intensity of the lesions was heterogeneous, and among the 15 patients who underwent MRI, 14 cases showed uneven slightly hyperintensity with hypointense strips on T 2WI, moderate or significant enhancement. TIC showed a persistent pattern in 9 cases, and a plateau pattern in 6 cases. The ADC value was (0.99±0.21)×10 -3 mm 2/s. Intermediate type: The 2 cases were single, irregular in shape, without involvement of adjacent subcutaneous tissue and skin, with obvious enhancement and no necrosis. And 28 cases of diffuse type and 2 cases of nodular type were accompanied by ipsilateral or bilateral cervical lymphadenopathy. The enlarged lymph nodes had clear boundaries, homogeneous density or signal intensity, and homogeneous enhancement. Conclusions:The Kimura disease in parotid region has a long clinical course and elevated peripheral blood eosinophils. The diffuse type is more common in the morphology, with multiple ill-defined lesions in and around the parotid gland, and can be accompanied by similar subcutaneous lesions in other parts of the head and neck with obvious enhancement, accompanied by cervical lymph node enlargement. TIC shows persistent pattern or plateau type, and the ADC value is low. The nodular type and intermediate type are rare.

Objective:To determine the correlation between the radiologic magnetic resonance imaging(MRI)depth of invasion(MRI-DOI)and pathologic depth of invasion(p-DOI)in oral cavity primary tongue squamous cell carcinoma(TSCC).Methods:Fifty-two cases of patho-logically proven primary TSCC were selected from patients admitted to The Ninth People's Hospital Affiliated to Shanghai Jiao Tong Uni-versity School of Medicine between January 2015 and December 2018.The p-DOI was measured,and the relationship between p-DOI and patients'clinicopathological parameters and prognosis were analyzed.The MRI-DOI was retrospectively measured,and the correlation between MRI-DOI and p-DOI was investigated.Results:Among the 52 patients,the average p-DOI was(8.5±5.5)(1-30)mm.p-DOI was signi-ficantly correlated with tumor size(P=0.021)and tumor site(P=0.047)when p-DOI was>5 mm,and significantly correlated with level Ⅲ lymph node metastasis(P=0.01)when p-DOI was≥10 mm.A close relationship between p-DOI>7 mm and the patient 5-year survival was also demonstrated(P=0.048).The average MRI-DOI was(10.3±4.3)mm,with a maximum of 19.9 mm and a minimum of 3.1 mm.The MRI-DOI≥10 mm also predicted poor survival in patients with TSCC(P=0.043).The MRI-DOI measured was generally slightly higher than p-DOI,with an average difference of 1.94 mm,and a strong correlation was found between MRI-DOI and p-DOI(r=0.831,P<0.001).Conclusions:MRI-based radiologic DOI measurement was useful in estimating postoperative p-DOI,and may help predict the depth of invasion of tumors preoperatively,which has important reference value for treating primary TSCC.

OBJECTIVE：To construc t the evaluation system of the research quality of medical insurance budget impact analysis （BIA），and to provide feasible evaluation tool for related departments as medical insurance department. METHODS ：Based on BIA guidance documents and relevant empirical literatures of ISPOR ，Canada，Poland，the United States and other countries ， combined with expert interview ，the relevant elements of medical insurance negotiation BIA material were confirmed （including key elements and adjuctive elements ）. The scale and system was established to calculate total score of BIA research quality evaluation. RESULTS ：Key elements included three data blocks as target population ，market situation and treatment cost ，involving 14 key elements such as total population ，new drug scenario market share ，treatment cost ，etc.. According to the degree of compliance，0-3 points were assigned and the lowest score after normalization was taken as the basic score of BIA research quality. The adjunctive elements included five data blocks as title & abstract ，research background ，analysis framework ，result presentation and other ，including 23 adjunctive elements such as title ，abstract，research angle ，research time limit ，etc.. According to whether there is quality grade difference ，the elements were divided into type A and type B ；the grade score （0-4 points）and 0/1 score（1 point for yes and 0 point for no ）were used respectively ，and the additional score of BIA research quality was obtained after calculation and addition. According to the addition of different weights （0.67 and 0.33）of basic score and additional score ，the total score system of BIA research quality evaluation could be calculated. CONCLUSIONS ：This study successfully constructed a new BIA quality evaluation system ，which can be used for the quality evaluation of BIA research submitted by medical insurance drug negotiation.

Objective:To study the expression of programmed death ligand-1 (PD-L1) in tumor cells and CD8 +T lymphocytes in tumor infiltrating lymphocytes, and to analyze the correlation of PD-L1 expression with infiltration of CD8 +T lymphocytes and clinicopathologic features in salivary gland lymphoepithelial carcinoma (LEC). Methods:Forty-two cases of primary salivary LECs and 21 cases of secondary salivary LECs were enrolled at the Department of Oral Pathology, Shanghai Ninth People′s Hospital, Shanghai Jiaotong University between 2015 and 2017. The expression of Epstein-Barr (EB) virus, PD-L1 and CD8 was examined using chromogenic in situ hybridization (CISH) and immunohistochemistry (IHC) staining. The data were analyzed using SPSS 23.0 software package.Results:EB virus was detected in 61 cases (61/63, 96.8%), including 42 (42/42, 100%) primary LECs and 19 (19/21, 90.5%) secondary LECs. The PD-L1 positive rate (score ≥1) was 97.6% (41/42), and its high-expression rate (score ≥20) was 78.6% (33/42) in primary LECs. The PD-L1 positive rate (score ≥1) was 71.4% (15/21), and its high-expression rate (≥20) was 38.1% (8/21) in secondary LECs. However, the PD-L1 positive rate (score ≥1, P=0.004) and high-expression rate (score ≥20, P=0.001) in primary LECs were higher than those in secondary LECs. There was no difference in the infiltration degree of CD8 +T lymphocytes between primary and secondary LECs. There was a significant correlation between the expression of PD-L1 and CD8 in primary LECs ( P=0.001) and in secondary LECs ( P=0.048), respectively. Conclusions:There is PD-L1 expression in primary and secondary salivary LECs, while the expression rate is higher in primary LECs than secondary LECs. The combination of PD-L1 expression and CD8 +T lymphocytes′ presence suggest that most LEC patients might be responsive to immunotherapy, and primary LECs might be more significantly responsive than secondary LECs.