Objective To assess the safety and efficacy of intra-arterial chemotherapy (IAC) for the treatment of young infants (≤ 6 months) with retinoblastoma (RB).Methods Together 21 (24 eyes) young infants (≤6 months) with RB who received IAC were included from January 2013 to February 2017 in this study and the clinical data were retrospectively analyzed.According to the international stages for intraocular retinoblastoma,stage B appeared in 4 eyes,stage D in 13 eyes,and stage E in 7 eyes.And there were two kinds of administration for chemotherapy,including perfusion chemotherapy of melphalan (≤ 0.5 mg · kg-1) combined carboplatin (20 mg) on the first and third IAC procedures,and melphalan (≤ 0.5 mg · kg-1) combined with topotecan (0.5-1.0 mg) on the second and fourth IAC procedures,and the dose of melphalan was appropriately adjusted according to the tumor changes and the response of the child after the previous IAC.Then main outcome measures include successful rate for procedures,ocular preservation rate,local and systemic complications and the time and dose of radiation exposure during IAC were evaluated.Results Of the 70 IAC procedures performed on 24 eyes,69 procedures (98.6％) were successful,and 1 was failed due to ophthalmic spasm.IAC ranged from 2 to 4 cycles with mean 3.3 cycles.After IAC procedures,17 eyes presented fish-like changes or calcification or scar formation,and the overall ocular preservation rate was 70.8％,and the other 7 eyes (29.2％) underwent enucleation of the eyeballs due to fundus hemorrhage in 3 eyes and extensive vitreous implantation in 4 eyes.Postoperative adverse reactions included eyelid oedema in 8 patients,fundus hemorrhage in 3 eyes,ocular arteriospasm in 1 patients and bone marrow suppression in 9 patients.The mean irradiation time was 3.2-32.4 (6.3 ± 1.2) min for one IAC procedure and the mean irradiation dose was 5-153 (51.9 ±9.2)mGy.The cumulative irradiation time was 6.6-53.1 (19.2 ±0.9)min for each patient of IAC cycles and the cumulative irradiation dose was 41-281 (157.3 ± 13.1) mGy.Conclusion IAC is safe and effective for the treatment of young infants (≤≤ 6 months) with RB,and the irradiation dose in IAC is lower than the threshold dose that can cruise lens tissue reactions.

Objective:To explore the application value of modified Shiquan Dabutang in the treatment of elderly patients with osteoporotic intertrochanteric fractures （OIFs） due to Qi and blood deficiency by observing its impacts on inflammatory and bone metabolism indexes. Method:Ninety-eight elderly patients admitted to our hospital for OIFs of Qi and blood deficiency syndrome from April 2018 to April 2020 were randomized into an observation group （n=49） and a control group （n=49）. Following the proximal femoral nail antirotation （PFNA） fixation， patients in the control group were treated with Guipiwan， while those in the observation group received the modified Shiquan Dabutang. The clinical efficacy， inflammatory and bone metabolism indexes， and complications were compared between the two groups after four weeks of treatment. Result:The levels of such serum indexes as fibroblast growth factor-2 （FGF-2）， osteoprotegerin （OPG）， transforming growth factor-β₁ （TGF-β₁）， β-endorphin （β-EP）， bone-specific alkaline phosphatase （BALP）， and osteocalcin （BGP） in the observation group after treatment were significantly elevated as compared with those in the control group （P<0.05）， whereas the serum tumor necrosis factor-α （TNF-α） and D-dimer （D-D） declined （P<0.05）. The TCM symptom score in the observation group after treatment was obviously lower than that in the control group， while the Harris Hip Score （HHS） was higher （P<0.05）. The overall response rate of the observation group was 93.88% （46/49）， higher than 75.51% （37/49） of the control group （χ²=6.376， P<0.05）. The total incidence of incision infection， deep vein thrombosis of lower limbs， and pulmonary infection in the control group was 24.49% （12/49）， significantly higher than 6.12% （3/49） in the observation group （χ²=6.607， P<0.05）. Conclusion:The modified Shiquan Dabutang is able to alleviate inflammation， regulate bone metabolism， promote bone repair， and reduce the incidence of complications in elderly patients with OIFs due to Qi and blood deficiency.