Objective To explore the safety and efifciency of oral iron therapy and intravenous iron therapy in anemia patients with maintenance hemodialysis,in order to gain experience for clinical treatment of this disease. Methods 88 cases collected in the ifrst people's hospital of Changshu city from July 2010 to March 2013 were divided into research group(n=44) and control group(n=44) by random number table. Control group was given oral iron therapy, and research group was t given intravenous iron. The differences of hemoglobin (Hb), reticulocyte, serum ferritin content, superoxide dismutase (SOD) and serum malondialdehyde (MDA) before and after treatment between two goups were recorded and compared. Results The differences of Hb, serum ferritin and reticulocyte numerical before treatment between two groups were not signiifcant, but signiifcant four weeks after treatment, with higher level in research group(P<0.05).The difference of oxidative stress status before treatment between two groups was not signiifcant, but after treatment, the MDA level in research group was higher than control group(P<0.05),while SOD level was lower than control group(P<0.05). Conclusion Compared with oral iron therapy, intravenous iron has better results in improving anemia, but easy to induce oxidative stress reaction.

Objective To investigate the clinical therapeutic effect of radiofrequency catheter ablation in treatment of atrial fibrillation. Methods The clinical data of 30 cases of patients with atrial fibrillation that had application of ra-diofrequency catheter ablation from November 2010 to January 2013 in our hospital were analyzed. Type of atrial fib-rillation: 26 patients with paroxysmal atrial fibrillation, 4 patients with persistent atrial fibrillation. Results There were 40 times of ablation, 30 patients reached the endpoint of ablation, average power of 25 W. Atrial fibrillation ablation in 30 patients were all successful, 1 cases only annular isolated right inferior pulmonary vein, and both of right and left inferior pulmonary vein isolation ring in 12 cases. In the follow-up period, there were no cases of pulmonary vein stenosis, cardiac perforation, pneumothorax, cardiac arrest and esophageal perforation. Vagal reflex occurred in 3 cases of atrial fibrillation patients, atropine injection after the return to normal. Among the 26 cases of patients with paroxysmal atrial fibrillation ablation conversion to sinus rhythm in 16 cases, all patients after 3 months of stopping amiodarone and propafenone antiarrhythmic drugs. Conclusion Transcatheter radiofrequency ablation of atrial fibrillation can reduce heart failure and thrombosis and other complications, minimally invasive, and it has advantages of short operation time, good effect, which is worthy of promotion and application.

Objective:To explore the effect of Dachengqi Decoction on the postoperative recovery of laparoscopic gastrectomy under general anesthesia.Methods:From March 2015 to May 2018, 96 patients with gastric cancer undergoing laparoscopic gastrectomy under general anesthesia in our hospital were selected as the study objects and divided into two groups according to the random number table method. The control group received routine nursing. The observation group received the intervention of Dachengqi Decoction with ultrasonic conductivity on the basis of the control group. The recovery of gastrointestinal function, the levels of gas (serum gastrin), MTL (plasma motilin) and Quality of Recovery 40 (QoR40) were compared between the two groups.Results:The gastrointestinal function indexes of the observation group were better than those of the control group ( P<0.05). Compared with one day before operation, the levels of gas and MTL in the two groups were lower 24 hours after operation, but the levels of GAS and MTL in the observation group were (92.56±5.12), (258.58±5.59) ng/L, which were higher than (52.12±3.15), (185.63±4.12) ng/L in the control group ( t values were 46.608, 72.782, P<0.01). Compared with the pre intervention group, QoR40 scores of the two groups were improved after intervention, and the observation group was (198.56±5.58) points, which was higher than (152.12±2.63) points of the control group ( t value was 52.157, P<0.01). Conclusion:Dachengqi Decoction can promote the recovery of patients after laparoscopic gastrectomy under general anesthesia.

Objective:To investigate the expression of programmed death ligand 1 (PD-L1) in rectal cancer tissues and the correlation of PD-L1 expression with clinicopathological characteristics and overall survival of patients.Methods:The clinical data of 200 newly treated rectal cancer patients in Shanxi Provincial Cancer Hospital from January 2014 to December 2015 were retrospectively analyzed. The expression of PD-L1 in rectal cancer tissues was detected by immunohistochemistry. The correlations of PD-L1 expression with gender, age, tumor T stage, lymph node metastasis, tumor differentiation, histological type, tumor TNM stage, neutrophil-to-lymphocyte ratio (NLR) and overall survival of patients were analyzed.Results:The positive expression rate of PD-L1 was 24% (48/200). The positive expression rate of PD-L1 was high in patients with lymph node metastasis and high NLR (≥ 3.5) (both P < 0.05). The 5-year overall survival rate in PD-L1-positive group was 42%, and the PD-L1-negative group was 59%, and the difference between the two groups was statistically significant ( P < 0.05). The results of multivariate analysis showed that lymph node metastasis ( HR = 3.456, 95% CI 2.148-5.556, P < 0.01), NLR ≥ 3.5 ( HR = 1.871, 95% CI 1.169-2.996, P = 0.009), and PD-L1-positive expression ( HR = 2.187, 95% CI 1.373-3.484, P = 0.001) were independent adverse influencing factors for the overall survival of rectal cancer patients. Conclusion:PD-L1 is highly expressed in rectal cancer tissues, and the positive expression of PD-L1 is associated with poor overall survival of patients.

Objective:To explore the clinical value of 18F-fluoromisonidazole (FMISO) PET/CT hypoxia imaging in early response to heavy ion radiotherapy in patients with non-small cell lung cancer(NSCLC). Methods:From April 2018 to January 2021, the 18F-FMISO PET/CT images of 23 NSCLC patients (19 males, 4 females; age (64.9±10.3) years) who received heavy ion radiotherapy in Shanghai Proton and Heavy Ion Center were retrospectively analyzed. The evaluation parameters included tumor volume (TV), tumor to background ratio (TBR) before and after radiotherapy. Patients were divided into hypoxia group and non-hypoxia group with the baseline TBR value≥1.4 as hypoxia threshold. Wilcoxon signed rank test was used to compare the differences of TV and TBR before and after radiotherapy in 2 groups. Results:Of 23 NSCLC patients, 17 were hypoxia and 6 were non-hypoxia. Compared with the baseline, TV after the radiotherapy (59.44(22.86, 99.43) and 33.78(8.68, 54.44) cm 3; z=-3.05, P=0.002) and TBR after the radiotherapy (2.25(2.09, 2.82) and 1.42(1.24, 1.67); z=-3.39, P=0.001) of the hypoxia group were significantly lower, while TV (16.19(6.74, 36.52) and 8.59(4.38, 25.47) cm 3; z=-1.57, P=0.120) and TBR (1.19(1.05, 1.27) and 1.10 (0.97, 1.14); z=-1.89, P=0.060) of the non-hypoxia group decreased with no significant differences. Conclusions:Hypoxic NSCLC tumors are sensitive to heavy ion radiation. Compared with non-hypoxic tumors, hypoxic tumors respond more quickly, and a significant reduction in TV can be observed early after radiotherapy. Heavy ion radiation can significantly improve tumor hypoxia.

Objective: To verify the safety and efficacy of IONTRIS particle therapy system (IONTRIS) in clinical implementation. Methods: Between 6.2014 and 8.2014, a total of 35 patients were enrolled into this trial: 31 males and 4 females with a median age of 69 yrs (range 39-80). Ten patients had locally recurrent head and neck tumors after surgery, 4 cases with thoracic malignancies, 1 case with hepatocellular carcinoma, 1 case with retroperitoneal sarcoma, and 19 cases with non-metastatic prostate carcinomas. Phantom dose verification was mandatory for each field before the start of radiation. Results: Twenty-two patients received carbon ion and 13 had proton irradiation. With a median follow-up time of 1 year, all patients were alive. Among the 16 patients with head and neck, thoracic, and abdominal/pelvic tumors, 2, 1, 12, and 1 cases developed complete response, partial response, stable disease, or disease progression, respectively. Progression-free survival rate was 93.8% (15/16). Among the 19 patients with prostate cancer, biological-recurrence free survival was 100%. Particle therapy was well tolerated in all 35 patients. Twenty-five patients (71.4%) experienced 33 grade 1 acute adverse effects, which subsided at 1 year follow-up. Six (17.1%) patients developed grade 1 late adverse effects. No significant change in ECOG or body weight was observed. Conclusions IONTRIS is safe and effective for clinical use. However, long term follow-up is needed to observe the late toxicity and long term result.