Objective:To investigate the clinical efficacy and safety of anlotinib combined with docetaxel for the treatment of advanced non-small cell lung cancer.Methods:A total of 118 patients with advanced non-small cell lung cancer who received treatment in Jinhua Guangfu Cancer Hospital from March 2018 to June 2019 were included in this study. They were randomly assigned to receive treatment with either anlotinib combined with docetaxel (study group, n = 59) or docetaxel alone (control group, n = 59) for two treatment courses. Clinical efficacy, progression-free survival, 1-year survival rate, and adverse drug reactions were compared between the study and control groups. Results:There was no significant difference in the objective remission rate between the two groups (22.03% vs. 32.20%, χ2 = 1.544, P = 0.214). The disease control rate in the study group was significantly higher than that in the control group (88.14% vs. 69.49%, χ2 = 6.141, P = 0.013). Progression-free survival in the study group was significantly longer than that in the control group [6.92 months (95% CI: 3.83-9.54 months) vs. 3.84 months (95% CI: 2.08-6.17 months), χ2 = 5.934, P = 0.019). The 1-year survival rate in the study group was significantly higher than that in the control group [52.47% (31/59) vs. 32.20% (19/59), χ2 = 4.998, P = 0.025]. During the treatment, the proportion of patients having leucopenia, erythropenia, gastrointestinal adverse reactions and abnormal liver and kidney function in the study group was 20.34%, 13.56%, 28.81% and 5.08%, respectively, which was significantly higher than 16.95%, 10.17%, 23.73% and 3.39%, respectively in the control group ( χ2 = 0.211-0.835, P = 0.361-0.646). Conclusion:Arotinib combined with docetaxel can effectively inhibit the progression of non-small cell lung cancer, prolong the progression-free survival, increase the 1-year survival rate, and does not increase adverse drug reactions.

OBJECTIVETo explore the nerve regeneration mechanism of electroacupuncture (EA) combined with polysaccharide of gastrodia elate blume (PGB) for secondary thalamic damage of focal cerebral ischemia.

METHODSForty Sprague-Dawley adult rats were randomly divided into a normal control group, a model group, an EA group, a PGB group and an EA + PGB group, 8 rats in each group. The rat model of right middle cerebral artery occlusion was prepared by suture-occluded method. Two weeks after model establishment, rats in the normal control group and model group received no treatment; rats in the EA group were treated with EA at "Baihui" (GV 20) and left "Zusanli" (ST 36), 30 min per treatment, once a day for 14 successive days; rats in the PGB group were treated with intragastric administration of PGB (100 mg/kg) , once a day for 14 days; rats in the EA + PGB group were treated with EA and PGB treatment, once a day for totally 14 days. The expressions of nestin and stem cell factor (SCF) in thalamic ventroposterolateral nucleus (VPL) were detected by immunohistochemical method.

RESULTSThere were positive cells of nestin in ischemia VPL in the model group, and the number of SCF positive cells was increased compared with that in the normal control group (P<0.05). The number of positive cells of nestin and SCF in ischemia VPL in the EA group, PGB group and the EA + PGB group was increased compared with that in the model group (all P<0.05), and the average gray value of immune positive product was all reduced (all P<0.05). The number of positive cells of nestin and SCF in the EA + PGB group was higher than that in the EA group or the PGB group (all P<0.05).

CONCLUSIONEA combined with PGB can significantly increase the SCF expression in ischemia VPL and promote the proliferation of neural stem cells, which is likely to be one of the nerve regeneration mechanism of acupuncture and medication tor secondary thalamic damage of local cerebral isctemia.

Animals ; Brain Ischemia ; drug therapy ; genetics ; metabolism ; therapy ; Combined Modality Therapy ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Electroacupuncture ; Gastrodia ; chemistry ; Humans ; Male ; Nestin ; genetics ; metabolism ; Polysaccharides ; administration & dosage ; Rats ; Rats, Sprague-Dawley ; Stem Cell Factor ; genetics ; metabolism ; Thalamic Nuclei ; metabolism

Objective To evaluate long-term changes in health-related quality of life (QOL) of patients with local advanced prostate cancer after intensity modulated radiotherapy (IMRT) combined with androgen deprivation therapy.Methods The patients who met the criteria for this study were enrolled and were treated with IMRT combined with androgen deprivation.The total dose of radiation was 68.2Gy(2.2Gy per fraction).QOL was evaluated before and 3,12,36,48 and 60 months after treatment using the Expanded Prostate Cancer Index Composite(EPIC),a validated tool that assesses four primary domains (urinary,bowel,sexual and hormonal).Results From 2002 to 2007,87 patients were enrolled.At each follow-up time point,the number of cases was 87,87,86,81,75,65,56 and 47,respectively.The median follow-up time was 76.8 months.Compared with baseline assessment,all of four domain scores were declined in follow-up assessments.The mean score of urinary,bowel and hormonal domains were significantly reduced.At 3 months after treatment,the scores of bowel domain were lowest,in which the total,function and symptom scores were 75.7,78.4 and 72.8,respectively.However,there was no statistically significant difference in the mean sexual domain score.The mean change scores in urinary incontinence and obstructive were-13.0±8.3 and-6.12±3.9,respectively.Conclusions IMRT combined with androgen deprivation therapy was well tolerated in patients with local advanced prostate cancer.QOL was decreased in urinary,bowel and hormonal toxicity,most of which could be tolerated in five years.

Objective To investigate the effects of a novel standardized training program on the satisfaction and training quality of general practitioners (GPs). Methods 114 GPs trained in Wuxi People's Hospital between 2009 and 2013 were included, 52 GPs and 62 GPs were trained before and after the reform respectively. The measures of teaching reform included improvements in curriculum provision, theory teaching, learning modality and skills training. The evaluation indexes of satisfaction questionnaire and examination were confirmed by literature method and small-group discussion. Self-report satisfaction ques-tionnaire were distributed to graduate GPs and valid questionnaires were collected, while the results of entrance examination and graduation examination of GPs were recorded before and after the teaching reform. The research data were analyzed by chi-square test using SPSS 16.0 software. Results The basic characteristics of GPs and results of entrance examination before and after the teaching reform were compa-rable (P>0.05), however, GPs' satisfaction with curriculum, theoretical education, study form and skill training were increased significantly after teaching reform (P<0.05). Besides that,the results of graduation examination of GPs after the teaching reform, both the theory and skill examination, were improved signifi-cantly (P<0.05). Conclusion The study showed that GPs satisfaction with training modality and the results of graduation examination were improved greatly through our innovative teaching reform.

Objective:To observe the differences in biochemical indexes and AIDS-related complications at baseline in HIV-infected patients with different levels of immune reconstitution to antiretroviral therapy (ART).Methods:The subjects were treat-na?ve adult HIV-infected patients who were followed up for more than 24 months in the Guangzhou Eighth People's Hospital affiliated infection clinic at Guangzhou Medical University from January 2010 to December 2017. CD4 + T lymphocyte count at baseline at <200, 200-350, and >350 cells/μl levels were divided into poor, partial, and good immune reconstitution groups. The Kruskal-Wallis H and chi-square tests were used to analyze the differences in baseline sociodemographic characteristics, biochemical indexes, and AIDS-related complications among different groups. The SPSS 20.0 software was used for statistical analysis. Results:Among the 3 900 HIV-infected individuals, 385 cases (9.9%), 1 206 cases (30.9%), and 2 309 cases (59.2%) were grouped into poor, partial and good immune reconstitution groups, respectively. The baseline biochemical indexes of leukocyte, platelet, hemoglobin, TG, TC, FPG, AST, ALT and total bilirubin in the poor immune reconstitution group were significantly different from those in the good immune reconstitution group (all P<0.05). The proportion of AIDS-related complications at baseline in the poor immune reconstitution group, such as tuberculosis, pneumocystis yeli pneumonia, disseminated mycosis, esophageal candidiasis, extrapulmonary tuberculosis, dermatitis, oral candidiasis, oral mucous leukoplakia, continuous diarrhea for more than 1 month and continuous or intermittent fever for more than 1 month, was significantly higher than that in the good immune reconstitution group (all P<0.05). Conclusions:The biochemical indexes and AIDS-related complications in HIV-infected patients with different levels of immune reconstitution were significantly different at baseline. Attention should be paid to monitoring abnormal biomedical indicators and AIDS-related complications at baseline.

Objective To investigate the clinical features of of patients with Staphylococcus aureus blood-stream infection and risk factors for septic shock.Methods A total of 51 patients diagnosed with Staphylococ-cus aureus bloodstream infection in the hospital from January 2018 to March 2023 were enrolled in the study.According to whether the patients developed septic shock,they were divided into septic shock group and non-septic shock group.The clinical data of the patients were collected,and the clinical laboratory indicators were detected on the day of blood culture samples were collected.Bacteria isolated from blood culture specimens of patients were identified and tested for drug sensitivity.The clinical data and clinical laboratory test indicators of the two groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors of septic shock in patients with Staphylococcus aureus bloodstream infection.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of clinical laboratory test indicators for septic shock in patients with Staphylococcus aureus bloodstream infection.Results Septic shock occurred in 12 of 51 patients,with an incidence of 23.5％.The proportion of patients with diabetes,gouty arthritis,the proportion of patients with long-term glucocorticoid use,the proportion of patients with respiratory tract in-fection,the proportion of patients who died,and the hospitalization cost in the septic shock group were higher than those in the non-septic shock group,and the differences were statistically significant(P＜0.05).Long-term glucocorticoid use was an independent risk factor for septic shock in Staphylococcus aureus bloodstream infection(P＜0.05).The combination of C-reactive protein(CRP),albumin(Alb),neutrophil/lymphocyte ratio(NLR)and procalcitonin(PCT)had high value in predicting septic shock in patients with Staphylococ-cus aureus bloodstream infection,and the area under the ROC curve was 0.983.Conclusion Long-term use of glucocorticoids can lead to an increased risk of septic shock in patients with Staphylococcus aureus blood-stream infection.The combined detection of CRP,Alb,NLR and PCT has a higher predictive value than single detection for septic shock in patients with Staphylococcus aureus bloodstream infection.

Objective:To investigate the utilization of sexual health services among community-based older adults in Chongqing and explore its potential correlates.Methods:A cross-sectional survey using multistage sampling among community-based older adults aged ≥50 years was conducted in Chongqing between June 2020 and December 2022. A questionnaire including information on demographic characteristics, general health, sexual health status, and sexual health services utilization was collected. Sexual health and reproductive services utilization was defined as having ever been tested for human immunodeficiency virus (HIV), or having had a male/gynecological reproductive health examination in the past year. Logistic regression was used to examine the correlates of the utilization of sexual health services.Results:A total of 794 community-based older adults participated in the study (482 were male, and 312 were female). The mean age was (62.8±8.2) years. The proportion of HIV testing was 18.0%, and the proportion of reproductive health examination was 10.1% among community-based older adults. The results of multivariate logistic regression analysis showed that the age group of 60-69 years (a OR=0.37, 95% CI: 0.18-0.76), female (a OR=11.34, 95% CI: 5.71-22.52), monthly income ≥5 000 yuan (a OR=3.05, 95% CI: 1.01-9.27), being sexual activity (a OR=4.99, 95% CI: 2.23-11.15) was significantly associated with had a reproductive health examination in the past year. Conclusions:The proportion of sexual health services utilization among older adults was low. Older sexual health education should be further strengthened, the close relationship between older adults should be correctly guided and dealt with, and the sexual health services suitable for the older population should be formulated.

Objective To study the expression of hypoxia-inducible factor-1a(HIF-1α) at mRNA and protein levels in the early stage of hypoxic-ischemic brain damage (HIBD) in neonatal rats and its role.Methods (1) Experiment 1:thirty-six postnatal 7-day SD rats were divided into Sham group (n =6) and model group (HIBD,n =30) according to the random table method,then the rats in the model group were divided into 5 subgroups according to the time of sacrifice after HIBD(6 h,12 h,24 h,48 h,72 h,n =6).The expression levels of HIF-1cα mRNA and protein were detected by quantitative Real-time PCR(qPCR) and Western blot,respectively.(2) Experiment 2:forty-five postnatal 7-day SD rats were randomized into 3 groups:Sham group (n =15),HIBD group (n =15) and 2-methoxyestradiol(2ME2) group(n =15).According to the experiment 1,at the time point of the highest expression levels of HIF-1 α mRNA and protein,rats were killed and the brains were collected.The location and expression of HIF-1 α protein were detected by immunofluorescence,histopathological changes of brain were observed by HE staining,brain water content was measured by dry-wet method,cell apoptosis was detected by nick end labeling(TUNEL) method.Results At the early stage of HIBD,the expression levels of HIF-1 α mRNA and protein increased at first and then decreased,and the mRNA expression level (3.38 ± 0.21) and protein expression level (2.81 ± 0.36) were the highest at 24 h after HIBD.In Sham group,HIF-1 α protein was mainly expressed in the cytoplasm,while in HIBD group it was mainly expressed in the nucleus.The number of HIF-1α staining positive cells,brain water content and apoptosis rate were significantly different among Sham group,HIBD group and 2ME2 group (all P ＜ 0.05),and which were significantly lower in 2ME2 group than those in HIBD group (all P ＜ 0.05),and the pathological changes were also less serious than those in HIBD group.Conclusions The mRNA and protein levels of HIF-1 α are the highest at 24 h after HIBD.Inhibiting the expression of HIF-1 α can ameliorate the brain damage of neonatal rats induced by hypoxia-ischemia.Therefore,it is hypothesized that HIF-1α may cause injury in the early stage of HIBD in neonatal rats.

Occupational contact dermatitis (OCD) is an occupational inflammatory skin disease. According to its pathogenesis, it can be divided into irritant contact dermatitis and allergic contact dermatitis. This review introduced the high-risk occupations of OCD, its incidence, common irritants and allergens, and corresponding treatments. Agriculture workers, construction workers, production workers, hairdressers, and medical workers are high-risk occupations of OCD who should be paid attention to.

Objective To understand the virus-carrying status and infection condition of Culicoides in Yunnan province.Methods Culicoides, cattle serum samples and pig serum samples were collected in Qujing City in Yunnan province from Sep.to Nov.in 2011; the supernatant of Culicoides was inoculated in C6/36 cells to isolate virus.Suspected isolates were identified by molecular biology techniques and titers of virus antibodies in pigs and cattles serum samples were tested by VN.Results 8 300 short tarsal Culicoides (8 300/18 160) and 7 100 Ryukyu Culicoides (7 100/18 160) were identified among 18 160 Culicoides specimens.Two suspected virus strains were isolated and designated as SC093 and SC233.The nucleotide sequence homology of VP2, VP4 and VP8 sequences with Banna virus Chinese strain ( Accession number:AF134526) is up to 99%.1 out of 200 (1/200) cattle serum samples was antibody positive against Banna virus with 0.5%positive rate.And the neutralizing antibody titers of SC093 and SC233 with above Banna virus antibody positive cattle serum were 160 and 40.10 out of 535 ( 10/535 ) pig serum samples were antibody positive against Banna virus with 1.7%positive rate.And the neutralizing antibody titers of SC093 and SC233 with above Banna virus antibody positive pig serum samples were 80-320 and 20-80 respectively.Conclusions The SC093 and SC233 virus strains isolated from Shizong were identified to be Banna virus and it could cause infection in pigs and cattles.This is the first report that Banna virus was isolated from Culicoides.