Objective To observe the effect of spleen-strengthening and kidney-reinforcing method on leukopenia in patients with malignant tumor after chemotherapy.Methods Seventy-one patients with malignant tumor were randomly allocated to Group A(n=37) and Group B (n=34).Group A was treated with spleen-strengthening and kidney-reinforcing herbal medicine and chemotherapy and Group B with chemotherapy only. The treatment course lasted 28 days.Blood routine examination was carried out before chemotherapy and on 7 th,9 th,12 th,15 th,18 th and 21 st day of chemotherapy.Results In Group A,5 cases of leukopenia were found, 3 in degree Ⅰ, 1 in degree Ⅱ and 1 in degree Ⅲ,the incidence being 13.5%; In Group B,25 cases of leukopenia were found, 3 in degree Ⅰ,13 in degree Ⅱ,8 in degree Ⅲ and 1 in degree Ⅳ, the incidence being 73.5%. There was significant difference between the two groups (P

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Objective To verify the methodology for auditing dosimetric parameters in reference and non-reference conditions with thermoluminescent dosimeters (TLDs).Methods Under reference and non-reference conditions,the established TLD methods were used to observe the absorbed dose variations with depth,SSD,field size and 45 wedges for 10 photon beams at 5 hospitals.Dosimetric parameters,including doses at Dmax points in axis,on 5 electron beams of 9 MeV were measured.The measurement results were compared between the TLDs and plane parallel ionization chambers.Results For 6 MV photon beams,the relative deviation of between finger ionization chamber method and TLD chips was in the range of-1.7％ to 5.4％ under on-axis non-reference conditions,and-6.3％ to-0.6％ under off-axis non-reference conditions,respectively,all within the range of ≤ ± 7％ as required by the IAEA.The relative deviation between plane parallel chamber and TLD method was-2.3％ to 3.7％,within ± 5％ as required by the IAEA.Conclusions It is convenient and feasible to use TLD method for quality audits of dosimetric parameters in radiotherapy.

Objective:To investigate the fertility intention and psychological pressure of women of childbearing age in Yanshan County, Jiangxi Province, and to provide data support for the targeted promotion of fertility.Methods:Using the method of random sampling, women of childbearing age in 10 communities in Yanshan County, Jiangxi Province were given questionnaires and psychological stress rating tables to understand the basic information, the status of marriage and childbearing, childbearing intentions, and the Chinese version of the Perceived Stress Scale (CPSS) score, and explore the related factors that may affect childbearing intentions and psychological stress of women of childbearing age.Results:In this survey, 1 500 questionnaires were distributed to women of childbearing age, 913 of which were returned, and 65.0%(593/913) of them were willing to have children. The CPSS score of women of childbearing age was 8-28(16.84±2.75). The CPSS scores of women of childbearing age in different occupations were statistically significant ( P<0.05). Public officials (including civil servants and employees of public institutions) had the least psychological pressure, while self-employed and other (unemployed) had the most psychological pressure. There was no significant difference in CPSS scores among women of childbearing age with different education levels, annual income levels, marital status and willingness to have children (all P>0.05). The correlation analysis showed that there was a statistical significance between the psychological pressure of women of childbearing age and their occupation ( r=0.230, P<0.05), and there was no significant correlation between other factors such as education level, annual income, fertility desire, fertility status, etc. and psychological pressure (all P>0.05). Conclusions:The fertility intention desire of women of childbearing age in Yanshan County, Jiangxi Province is basically normal, and the desire to have more children is not strong. There is no significant correlation between fertility intention and psychological pressure. The psychological pressure of women of childbearing age is significantly related to their occupation.

X-ray imaging is an important method for the diagnosis of corona virus disease(COVID-19), but there is a risk of nosocomial infection during X-ray imaging diagnosis. By analyzing the process of X-ray imaging diagnosis and the possible infection factors in hospital, Jiangsu province took the lead in issuing the Guideline for the nosocomial infection prevention and control of X-ray imaging diagnosis of COVID-19. This guideline clarifies the basic requirements for controlling infections during X-ray imaging diagnosis, the specific measures for staff protection, disinfection of personnel and places, and the protection and disinfection of subjects, which is instructive for field work. It is worth noting that while focusing on controlling infections, the principle of optimal protection for medical exposure cannot be ignored.

Objective To evaluate the feasibility and value of multi-detector computed tomography venography (MDCTV) and three dimensional reconstruction image in the assessment of central venous occlusive disease in hemodialysis patients,and in the value of guiding interventional treatments.Methods Sixty hemodialysis patients with swelling of upper limbs were scanned by Toshiba 128-multislice spiral computed tomography (128-MSCT) and totally 80-100 ml non-ionic contrast media was injected into each of the patients via the peripheral veins of the contralateral limb with the rate of 4 ml/s.MSCT scanning was taken by the technique of intelligent triggering after setting scanning triggering threshold,with the monitoring point set in the development of the lumen of inferior vena cava,to detect the position and degree of vascular stenosis.The images were reformed as maximum intensity projection (MIP),volume rendering (VR),curved planar reformation and threedimensional image reconstruction technique.Results MDCTV clearly demonstrated the lesion location in all cases enrolled.Seventy-five occlusive lesions were detected in the total of 60 hemodialysis patients with swelling of upper limbs by MDCTV,of which the lesions of brachiocephalic vein was 47,superior vena cava 15 and subclavian vein 13.Among the 75 stenosis lesions,the number of complete occlusive,severe,moderate and mild stenosis was 31,24,19 and only 1,respectively.MDCTV provided information coincident with that of digital subtraction angiography (DSA),which the correlation index was 0.401,while DSA showed that number of complete occlusive,severe,moderate and mild stenosis was 49,7,14 and 5,respectively.Pereutaneous transluminal angioplasty was performed in 53 patients,and stent placement was done in 40 patients.After interventional treatments,swelling of upper limbs were obviously relieved and vascular accesses got functional recovery to the extent that they could meet the requirement of hemodialysis.Conclusions MDCTV is the first choice to evaluate the condition of central venous occlusive diseases of hemodialysis patients with advantages of non-invasion,high definition and three-dimensional reconstruction.It can provide accurate evaluations of the conditions of occlusive lesions,which can be of great clinical significance to subsequent interventional therapy.

Objective To evaluate the efficacy of bare mental stent (BMS) and covered stent (CS) in the treatment of complete central venous occlusive disease (CVOD) in hemodialysis patients.Methods A total of 66 cases of CVOD who have been treated by endovascular methods successfully in the First Affiliated Hospital of Sun Yat-sen University from Jan 2015 to Jan 2017 were enrolled in this study.According to the type of stent,the patients were divided into two groups,BMS group (n=46)and CS group (n=20).The demographic data,clinical signs and symptoms,and pre-procedure and post-procedure imaging data were followed up and recorded.The primary patency rates were calculated at 1,3,6,9,and 12 months.Results The related symptoms were improved within 2 day post-procedure.The primary patency rates of BMS group in 1,3,6,9 and 12 months were 97.83％,95.65％,69.56％,41.3％,and 34.78％ respectively.The rates of CS group were 100％,100％,95％,65％,and 60％respectively.They did not reached statistical significance for primary patency rates between two groups in 1,3,and 6 months (P ＞ 0.05 respectively).However,from 9 months after procedure,it began to show the significant difference between two groups (P ＜ 0.05).The median patency time of the CS group was (10.30±5.32) months,while BMS group was (8.52±0.49) months.The difference between the two groups was statistically significant (P=0.046).Conclusions Stent implantation for complete occlusion of central venous in hemodialysis patients can get credible effect.The use of CS for CVOD provides superior patency as well as patency time in long period after procedure as compared with BMS.

X-ray imaging is an important method for the diagnosis of corona virus disease(COVID-19), but there is a risk of nosocomial infection during X-ray imaging and diagnosis. By analyzing the process of X-ray imaging & diagnosis and the possible exposure factors in hospital, Jiangsu province took the lead in issuing the guideline for the nosocomial infection prevention and control of COVID-19 during X-ray imaging and diagnosis. This guideline clarifies the basic requirements for controlling infections during X-ray imaging and diagnosis, the specific measures for staff protection, disinfection of personnel and sites, and the protection and disinfection of subjects, which is instructive for on-site work. It is worth noting that while focusing on controlling infections, the principle of optimal protection for medical exposure cannot be ignored.

It was generally believed that muscular atrophy of paralyzed limbs after stroke was due to disuse. However, recent studies have found that secondary lesions of motor neurons in the contralateral anterior horn of the spinal cord and the decrease of motor units lead to denervation, which plays an essential role in muscular atrophy and muscle fiber type transition. This article reviews the phenomenon and mechanism of muscular atrophy and denervation of paralyzed limbs after stroke, to provide a reference for clinical evaluation and experimental research.

Multiple cancer immunotherapies including chimeric antigen receptor T cell and immune checkpoint inhibitors (ICIs) have been successfully developed to treat various cancers by motivating the adaptive anti-tumor immunity. Particularly, the checkpoint blockade approach has achieved great clinic success as evidenced by several U.S. Food and Drug Administration (FDA)-approved anti-programmed death receptor 1/ligand 1 or anti-cytotoxic T lymphocyte associated protein 4 antibodies. However, the majority of cancers have low clinical response rates to these ICIs due to poor tumor immunogenicity. Indeed, the cyclic guanosine monophosphate-adenosine monophosphate synthase‒stimulator of interferon genes‒TANK-binding kinase 1 (cGAS‒STING‒TBK1) axis is now appreciated as the major signaling pathway in innate immune response across different species. Aberrant signaling of this pathway has been closely linked to multiple diseases, including auto-inflammation, virus infection and cancers. In this perspective, we provide an updated review on the latest progress on the development of small molecule modulators targeting the cGAS‒STING‒TBK1 signaling pathway and their preclinical and clinical use as a new immune stimulatory therapy. Meanwhile, highlights on the clinical candidates, limitations and challenges, as well as future directions in this field are also discussed. Further, small molecule inhibitors targeting this signaling axis and their potential therapeutic use for various indications are discussed as well.