Objective To develop a new type of lumbar puncture needle to facilitate to measure intracranial pressure,decrease the risks for intracranial infection and brain hernia.Methods The needle was composed of a body,no.1 and no.2 sleeves,a stylet,a needle base,a catheter,joints and etc.The needle had body and stylet made of stainless steel,the catheter manufactured with medical silicone tube,the joints produced by medical rubber and the remained components by medical plastics.Results The developed needle executed pressure measuring,cerebrospinal fluid collection and medication injection with no extracting the stylet.The outflow velocity of cerebrospinal fluid was limited,and the incidences of the complications were decreased including infection,brain hernia and etc.Conclusion The lumbar puncture needle has simple structure,easy operation and high safety,and thus is worthy promoting practically.

Objective To evaluate the clinical value and toxicities of docetaxel plus capecitabine in the first-line treatment of metastatic breast cancer (MBC),and compare the outcomes among different molecular subtypes.Methods A total of 108 patients with MBC who received docetaxel plus capecitabine combination treatment between January 1,2012 and December 31,2015 in Bejing Chaoyang District Sanhuan Cancer Hospital were retrospectively analyzed,and 104 cases were available for evaluation.The clinicopathological characteristics,clinical value and toxicities of these patients were evaluated.Results The patients were divided into 3 molecular subtypes,among 104 patients,85 patients in Luminal subtype,14 patients in triple negative breast cancer (TNBC) subtype,and 5 patients in human epidermal growth factor receptor-2 (HER-2) over expression subtype.The treatment achieved objective responses (OR) in 55 patients (52.9％),and the disease control rate (DCR) was 88.5％,including complete response (CR) in 4 patients,partial response (PR) in 51 patients,stable disease (SD) in 37 patients,and progressive disease (PD) in 12 patients.In Luminal subtype,4 patients achieved CR,43 PR,33 SD,and 5 PD.In TNBC subtype,6 patients achieved PR,3 SD,5 PD.In the HER-2 over expression subtype,2 patients achieved PR,1 SD,2 PD.There was no significant difference in the short-term therapeutic effect among 3 molecular subtypes (x2 =4.429,P =0.106).As a result,the progression-free survival (PFS) of the 104 patients was 1.5-121.0 months,and the median PFS was 10.0 months.The median PFS was 11.0 months in Luminal subtype,4.0 months in TNBC subtype and 10.3 months in HER-2 over expression subtype,with a significant difference (x2 =7.510,P =0.006).The most common adverse events were hand-foot syndrome (HFS),nausea or vomiting,neutropenia,anaemia,diarrhea and so on.The incidence of grade 2/3 HFS was 44.2％ (46/104),and the grade 3/4 neutropenia was 39.4％ (41/104).Conclusion The first-line treatment of MBC using docetaxel plus capecitabine is effective,and the toxicities can be tolerable,especially in the Luminal subtype.

BACKGROUNDThe concept of minimally invasive techniques is to make every effort to reduce tissue damage. Certainly, reducing skin incision is an important part of these techniques. This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF) with a small single posterior median incision.

METHODSDuring the period of March 2011 to March 2012, 34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group). The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group. The perioperative conditions of patients in these two groups were statistically analyzed and compared. The Oswestry Disability Index (ODI) scores, Visual Analog Scale (VAS) scores, and sacrospinalis muscle damage evaluation indicators before operation and 3, 12 months postoperation were compared.

RESULTSA total of 31 and 35 cases in the single incision and double incision groups, respectively, completed at least 12 months of systemic follow-up. The differences in perioperative conditions between the two groups were not statistically significant. The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01). The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation. However, these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05).

CONCLUSIONSMast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Spinal Fusion ; methods ; Treatment Outcome

Objective:To preliminarily observe the clinical efficacy of microwave hyperthermia combined with intensity-modulated radiotherapy (IMRT) and chemotherapy for patients with locally advanced gastric cancer.Methods:Forty patients who could not been operated or refused operation were enrolled in this clinical trial, who were confirmed as locally advanced proximal or distal gastric cancer by gastroscopy pathology and imaging. Radiotherapy was delivered by IMRT technology for 5 times per week with a total dose of 46 to 56 Gy (median dose of 50 Gy) in 25 to 28 fractions. Synchronous hyperthermia was given at 42 to 44℃ twice a week, 45 min/time. S-1 or capecitabine-based synchronous chemotherapy was performed, d1-14/3 weeks. The symptom remission rate, adverse reactions, objective remission rate (complete and partial remission) and survival were observed.Results:A total of 40 patients, aged between 56 and 83 years (median age of 71 years), were enrolled in this study. The male-to-female ratio was 7: 1. Among them, 38 cases (95%) showed symptom remission. The most common adverse reactions were grade 1-2 gastrointestinal reactions and leukopenia. The objective remission rate was 87.5%, the 2-year progression-free survival and overall survival rates were 68.6% and 70.5%, respectively.Conclusion:Preliminary findings demonstrate that microwave hyperthermia combined with chemoradiotherapy achieve satisfactory outcomes and yield tolerable toxicity in patients with locally advanced gastric cancer.

Objective:To determine the application effect of the "full chain" information-based health management model in the home care of children with bronchial asthma.Methods:Sixty children with bronchial asthma who were hospitalized in the Respiratory Department of Xuzhou Children's Hospital from January to June 2020 were selected and divided into a control group and an observation group according to a random number table with 30 cases in each group. The control group received routine nursing care, and the observation group implemented a "full-chain" informatized health management on the basis of the control group.The intervention time was 6 months. The condition control, medication compliance, self-management and airway function were observed and compared between the two groups.Results:After 6 months of intervention, the frequency of attacks, emergency cases, the medication compliance, the maximum expiratory flow rate, symptom days and peak expiratory flow days were 6.67%(2/30), 3.33%(1/30), 93.33%(28/30), (1.83±0.23) L, (163.00±6.74) d, (168.00±3.78) d in the observation group, and 26.67%(8/30), 20.00%(6/30), 66.67%(20/30), (1.67±0.24) L, (144.00±5.88) d, (157.00±4.08) d in the control group. The differences were statistically significant (χ 2 values were 4.320, 4.043, 6.667, t values were 2.636, 11.635, 10.833, P<0.05). There was no significant difference in the ratio of forced expiratory volume and forced expiratory volume in forced vital capacity in the first second after 6 months of intervention between the two groups ( P>0.05). Conclusions:"Full chain" information health management can reduce the number of attacks and emergency visits of children with asthma, effectively improve medication compliance, thus improving airway function and improving the quality of life of children.

Objective:To observe the short-term efficacy and safety of apatinib in combination with dose-dense paclitaxel and carboplatin in locally advanced triple-negative breast cancer (TNBC) patients.Methods:From September 2018 to September 2019, 17 stage Ⅱ/Ⅲ TNBC patients were enrolled in this single arm, single center prospective phase Ⅱ study. They received neoadjuvant treatment of apatinib 250 mg per day, paclitaxel 175 mg/m 2 on 1 st day and a dose of carboplatin according to the area under curve (AUC)=4 on 2 nd day, every 14 days as a cycle. Results:By January 2020, 16 cases completed 4-7 cycles of apatinib treatment and 4-8 cycles of chemotherapy. The median cycles of apatinib treatment and chemotherapy were 5 cycles and 6 cycles, respectively. Two cases achieved complete responses (CR), 12 achieved partial responses (PR), 2 achieved stable diseases (SD) and no progressive disease was observed. The objective response rate (ORR) was 87.5%, disease control rate (DCR) was 100%. By January 2020, among 12 patients who received surgery, 8 achieved pathologic complete response (pCR, 66.7%). The grade Ⅲ/Ⅳ adverse events included: neutropenia, thrombocytopenia in 3 cases (18.8%) each, anemia, fatigue, arrhythmia and alanine aminotransferase (ALT) elevation in 1 case each. Apatinib was interrupted in 5 cases, and was discontinued in 3 cases; chemotherapy dosage was reduced in 1 case.Conclusion:Apatinib in combination with dose-dense paclitaxel and carboplatin neoadjuvant therapy are effective and well tolerated in locally advanced TNBC patients.

Objective:To analyze the iodine nutritional status of children aged 8 - 10 in Tongren City, Guizhou Province, and provide a basis for scientific iodine supplementation for children.Methods:From 2020 to 2022, a systematic sampling method was adopted in 10 districts and counties of Tongren City. Each year, each district and county was divided into 5 districts based on east, west, south, north, and center. One township (street) was selected from each district, and 40 non boarding students aged 8 to 10 were selected from each township (street) to measure the iodine content of household salt and urine samples. The content of salt iodine in children of different yesas as well as the distribution of urine iodine in children of different districts and counties and different genders were analyzed and compared. Additionally, B-ultrasound was used to measure the thyroid volume of some children and the situation of thyroid enlargement was analyzed.Results:From 2020 to 2022, a total of 6 000 salt samples were collected and monitored from children's households, and 5 989 samples of iodized salt were detected, the coverage rate of iodized salt was 99.8%; and 5 750 samples of qualified iodized salt were found, the qualified rate of iodized salt was 96.0%, the consumption rate of qualified iodized salt was 95.8%; and the median salt iodine was 27.3 mg/kg, the difference in the median salt iodine among children between different years was statistically significant ( H = 10.04, P < 0.001). A total of 6 000 urine samples from children were tested, the median urinary iodine was 225.2 μg/L, the median urinary iodine among children in different districts and counties were statistically significantly different ( H = 85.73, P < 0.001); 3 077 male and 2 923 female urine samples were tested, and the median urinary iodine between different genders was statistically significant different ( Z = - 67.10, P < 0.001). The median urinary iodine of male samples were higher than those of female samples(227.8 vs 222.9 μg/L). The thyroid gland of 2 000 children was examined, and the rate of goiter was 1.0% (21/2 000). Conclusions:From 2020 to 2022, the consumption rate of qualified iodized salt, urinary iodine content and goiter rate of children in Tongren City have all met the national standard for eliminating iodine deficiency disorders. The overall iodine nutrition level exceeds the appropriate amount (urinary iodine of 200 - 299 μg/L).

Objective:To observe the short-term efficacy and safety of apatinib in combination with dose-dense paclitaxel and carboplatin in locally advanced triple-negative breast cancer (TNBC) patients.Methods:From September 2018 to September 2019, 17 stage Ⅱ/Ⅲ TNBC patients were enrolled in this single arm, single center prospective phase Ⅱ study. They received neoadjuvant treatment of apatinib 250 mg per day, paclitaxel 175 mg/m 2 on 1 st day and a dose of carboplatin according to the area under curve (AUC)=4 on 2 nd day, every 14 days as a cycle. Results:By January 2020, 16 cases completed 4-7 cycles of apatinib treatment and 4-8 cycles of chemotherapy. The median cycles of apatinib treatment and chemotherapy were 5 cycles and 6 cycles, respectively. Two cases achieved complete responses (CR), 12 achieved partial responses (PR), 2 achieved stable diseases (SD) and no progressive disease was observed. The objective response rate (ORR) was 87.5%, disease control rate (DCR) was 100%. By January 2020, among 12 patients who received surgery, 8 achieved pathologic complete response (pCR, 66.7%). The grade Ⅲ/Ⅳ adverse events included: neutropenia, thrombocytopenia in 3 cases (18.8%) each, anemia, fatigue, arrhythmia and alanine aminotransferase (ALT) elevation in 1 case each. Apatinib was interrupted in 5 cases, and was discontinued in 3 cases; chemotherapy dosage was reduced in 1 case.Conclusion:Apatinib in combination with dose-dense paclitaxel and carboplatin neoadjuvant therapy are effective and well tolerated in locally advanced TNBC patients.

Here we report the diagnosis and treatment of a rare IgG4-related kidney disease with nephrotic syndrome as the first manifestation. A 62-year-old male patient, presented with edema in both lower limbs and foam urine, had a history of "lung malignant tumor with brain and lymph node metastasis". The increase of IgG4 and decrease of glomerular filtration rate were detected at admission, and the pathological consideration of renal biopsy was membranous nephropathy with IgG4-related tubulointerstitial nephritis. After the combination of low-dose glucocorticoids therapy and rituximab treatment, the patient showed good prognosis in a 9 month follow-up.

ObjectiveTo investigate the effect of shikosin （SHI） on psoriasis （PSO） and explore the underlying mechanism via the cyclic guanosine monophosphate-adenosine monophosphate synthase （cGAS）/stimulator of interferon genes （STING） signaling pathway. MethodHaCaT cells were classified into normal culture（Control）， a mixture of five proinflammatory cytokines（M5）， low-， medium-， and high-dose SHI （L-SHI， M-SHI， and H-SHI， respectively）， and SHI+ADU-S100 groups. The cells in the M5 group were stimulated with 10 μg·L^-1 interleukin （IL）-1α， IL-17， IL-22， tumor necrosis factor （TNF）-α， and oncostatin M （OSM） for 48 h. The cells in the L-SHI， M-SHI， and H-SHI groups were treated with 0.1， 1， 10 μmol·L^-1 SHI， respectively， on the basis of the treatment in the M5 group. The cells in the SHI+ADU-S100 group were treated with 10 μmol·L^-1 STING activator ADU-S100 on the basis of the treatment in the H-SHI group. The methyl thiazolyl tetrazolium （MTT） assay and colony formation assay were employed to examine the effect of SHI on the proliferation of HaCaT cells. The wound healing assay was employed to examine the effect of SHI on the migration of HaCaT cells. Flow cytometry was employed to detect the effect of SHI on the apoptosis of HaCaT cells. Enzyme-linked immunosorbent assay was employed to measure the levels of IL-1β， IL-6， IL-15， IL-23， and interferon-γ （IFN-γ） in HaCaT cells. Western blot was employed to determine the protein levels of cGAS and STING in HaCaT cells. ResultCompared with Control group， the M5 group showed decreased survival rate， colony formation， and would healing rate of HaCaT cells， increased apoptosis rate， elevated levels of IL-1β， IL-6， IL-15， IL-23， and IFN-γ， and up-regulated protein levels of cGAS and STING （P<0.01）. Compared with the M5 group， the L-SHI， M-SHI， and H-SHI groups showed increased survival rate， cell colony formation， and wound healing rate， decreased apoptosis rate， lowered levels of IL-1β， IL-6， IL-15， IL-23， and IFN-γ， and down-regulated protein levels of cGAS and STING （P<0.01）. Compared with the H-SHI group， the SHI+ADU-S100 group showed decreased survival rate， cell colony formation， and wound healing rate， increased apoptosis rate， risen levels of IL-1β， IL-6， IL-15， IL-23， and IFN-γ， and up-regulated protein levels of cGAS and STING （P<0.01）. ConclusionSHI can inhibit the inflammation in the cell model of PSO by inhibiting the cGAS/STING signaling pathway.