ObjectiveTo explore the effect of neoadjuvant combined postoperative therapy on patients with hepatocellular carcinoma after radical operation. Methods41 postoperative cases were divided into 2 groups at random with 20 cases receiving hepatic artery chemotherapy embolization and biotherapy, and 21 cases receiving supporting treatment only.Results The intrahepatic tumor recurrence rate at 1 year and 2 years in treatment group was 10% (2/20) and 30% (6/20), compared with 43% (9/21) and 62% (13/21) in control group (all P

It is known that patients with vitiligo often have antibodies to melanocytes. In order to identify vitiligo antibodies react to corresponding antigens, we used cultured normal human melanocytes to react with sera from 48 patients with vitiligo, the result showed that 52% of patients with vitiligo have antibodies to cell-surface antigens of melanocytes. Then immunoprecipitation and SDS-PAGE analysis were used to reveal molecular weights (MW) of the antigens, the result showed that the MW are about 75 000, 90 000, 110 000, and 150 000.

Objective To study the effect of of human cytomegalovirus (HCMV) infection on the expressions of Hox genes.Methods Forty eight kunming mice were randomly divided into infection group (n=32) injected with HCMVAD169 and control group (n=16) injected with saline into their brain.After 7,15,30,and 60 days,the cerebral lesions were observed by pathological method.HCMV antigen was detected by immunohistochemical method and HCMV DNA was detected by polymerase chain reaction (PCR). On the basis of developing HCMV mouse model. reverse trancriptase-polymerase chain reaction (RT-PCR) was applied to determine the expressions of Hox gene in the brains of infected mice.The expression of Hox genes were also analysed with Northern-blot by isotope labelled Hox genes oligonucleotide probes. Results A HCMV infection model was developed and extensive pathological damages in brain tissue of infected mice were observed.Meanwhile.the HCMV-LA and HCMV-DNA were also found in brain tissues of HCMV infected mice.The expression level of Hox genes in control and infected mouse brain were determined by RT-PCR and Northern-blot.RT-PCR and Northern-blot showed that mouse brain expressed Hox-A9,Hox-A10,Hox-A11,Hox-A12,and Hox-A13,but they did not express Hox-B13.After HCMV infection,murine brain was induced to express Hox-B13 gene(P＜0.01),and reached the peak at 30 d after infection.Comparing with the control group,the expression of Hox-A9 and Hox-A11 were down-regulated in infected group (P＜0.05);the expression of Hox-A10 and Hox-A13 were significantly higher in infected groups (P＜0.05).Conclusion The results suggest that HCMVAD169 is able to cause mouse CNS infection and induced the abnormal expressions of Hox genes. which provides more information for understanding the mechanism of congenital abnormal due to HCMV infection and a valuable method of clinical prevention and treatment of HCMV infection.

Objective To evaluate the sufentanil-sparing effect of ketorolac tromethamine for postoperative analgesia in the elderly patients.Methods Sixty ASA Ⅱ or Ⅲ patients,aged ≥ 65 yr,with a body mass index of 18-24 kg/m2,undergoing elective gynecological operations,were randomly divided into 2 groups(n =30 each):sufentanil group(group S)and ketorolac tromethamine plus sufentanil group(group T).Both groups received combined intravenous-inhalational anesthesia and patient-controlled intravenous analgesia(PCIA)after operation.PCIA solution contained ketorolac tromethamine 180 mg and sufentanil 100 μg in 100 ml of normal saline in group T.After a loading dose of ketorolac tromethamine 30 mg was injected intravenously at 15 min before the end of operation,the PCA pump was set up with a 1.6 ml bolus dose,a 20 rain lockout interval and background infusion at a rate of 1.5 ml/h in group T.PCIA solution contained sufentanil 100 μg in 100 ml of normal saline in group S.After a loading dose of sufentanil 5 μg was injected intravenously at 15 min before the end of operation,the PCA pump was set up with a 1.6 ml bolus dose,a 20 min lockout interval and background infusion at a rate of 1.5 ml/h in group S.The effective analgesia(postoperative VAS scores at rest and during activity ＜ 3)was maintained within 48 h after operation.The amount of sufentanil consumed within 48 h after operation and adverse effects were recorded.Results Compared with group S,the amount of sufentanil consumed within 48 h after operation was significantly reduced,and the incidence of nausea and vomiting,urinary retention and pruritus was significantly decreased in group T(P ＜ 0.05).Conclusion Ketorolac tromethamine used with PCIA with sufenlanil has a significant sufentanil-sparing effecl for posloperative analgesia and improves the safety of analgesia in the elderly patients.

BACKGROUNDTo explore the therapeutic effect of bronchial artery infusion chemotherapy combined with immunotherapy for lung cancer with malignant hydrothorax.

METHODSSeventy-five lung cancer patients with malignant hydrothorax were randomly divided into the two groups: 38 patients were given intrathoracic chemotherapy and bronchial artery infusion chemotherapy combined with immunotherapy as observing group; 37cases only received intrathoracic chemotherapy as control group. Chi-square assay was performed to analyze the efficacy (responses for lung cancer and hydrothorax control) after the first course of treatment and the 1-, 2-year survival rates in the two groups.

RESULTSAfter the first course of treatment, the total responses for lung cancer were 31.58% (12/38) and 5.41% (2/37) in the observing group and control group (Chi-square=8.46, P < 0.01) respectively ; and responses for hydrothorax control were 86.84% and 64.86% respectively (Chi-square= 4.96, P <0.05). The 1- and 2-year survival rates in the observing group were 65.79% (25/38) and 26.32% (10/38) respectively, which were significantly higher than those of the control group (40.54% and 5.41%) respectively (Chi-square=4.80, P <0.05; Chi-square=6.10, P <0.05).

CONCLUSIONSThe intrathoracic chemotherapy combined with bronchial artery infusion chemotherapy and immunotherapy is quite effective in the treatment of lung cancer with malignant hydrothorax.

Objective To summarize and analyze the clinical characteristics,pathological features and follow-up data of patients with pulmonary lymphaugitic carcinomatosis(PLC) caused by gastric cancer.Methods A retrospective analysis was performed on 7 cases of gastric cancer with pulmonary carcinomatosis in Peking University People's Hospital between Jan 2000 and Dec 2017.Results 7 patients were identified from our database.All patients were female,with an average age of (54 ± 18) years.4 patients were treated with respiratory symptoms and 3 patients presented with gastrointestinal symptoms.One patient received gastrectomy,one did chemotherapy,5 patients had other site metastasis,one was still alive at the end of follow up.Patients average survival time was (4.8 ± 4.0) months.Conclusions Pulmonary lymphatic carcinomatosis caused by gastric cancer is rare clinical entity and the prognosis is poor.Patients often present with respiratory symptoms.Chest CT showed diffusely nodular thickening of interlobular septa and peribronchovascular interstitium.Biopsy of the gastric tumor often establish the diagnosis.

Objective To explore the influence of fixed-foot stance Yunshou combined with raising handclasp of Bobath on the recovery of upper extremity in post- stroke patients with hemiplegia. Methods Meeting the criteria 59 cases of stroke patients with hemiplegia were randomly divided into experimental group (29 cases) and control group(30 cases) according to random number table.All the patients in both groups were received routine therapy and nursing,besides,the patients in the control group were given raising handclasp of Bobath,while the patients in experimental group were treated with fixed-foot stance Yunshou combined with raising handclasp of Bobath.The intervention were once a day,five days a week,lasting eight weeks.The Fugl-Meyer Assessment of Upper Extremity(FMA-UE)and Modified Barthel Index(MBI) as well as Simple Test for Evaluating Hand Function(STEF) were used to assess the patients′condition before,8 weeks after treatment respectively. Results After 8weeks intervention,the scores of FMA-UE,MBI,STEF were 40.69±8.67,76.89±1.79,59.31±7.89 and before intervention were 24.17 ± 11.98,57.14 ± 13.93,31.83 ± 5.41, the difference between the experimental group before and after intervention was statistically significant(t=13.222,8.755,18.311,P<0.01).At 8 weeks,the scores of FMA-UE, MBI, STEF in the control group were 35.47 ± 9.68,73.17 ± 2.82,49.47 ± 8.78, and were17.38 ± 4.10,37.38 ± 4.30, 74.62 ± 11.22 respectively before intervention,all the measures in control groups had significantly improved than those before training (t=-4.797, 7.372, 17.139, P<0.01).Score of FMA-UE and STEF in the experimental group were higher than those in the control group,and the difference was statistically significant (t=2.180, 4.525, P<0.05 or 0.01), while the MBI had no statistically difference between two groups (P>0.05). Conclusion Compared with training on raising handclasp of Bobath alone,fixed-foot stance Yunshou combined with raising handclasp of Bobath is more effective On the recovery of upper limb function in stroke patients with hemiplegia.

The pricing and reimbursement of orphan drugs are related to the accessibility of patients,and are of great significance to the prevention and guarantee of rare diseases.European countries have formed special standards and paths for health technology evaluation,and established special payment funds and diversified risk-sharing agreements,which have effectively improved the accessibility of orphan drugs.Based on this,it selected typical European countries to compare the orphan drug pricing and reimbursement methods.Then,it put forward some suggestions"building orphan drug health technology evaluation accelerated program,exploring the health of orphan drug classification security mechanism,and attaining supply incentives and development incentives through orphan drug pricing and adjustment",to optimize the basis for the orphan drug market access mechanism to provide reference.

Objective:To explore the optimum time of ambulation of atrial fibrillation patients after radiofrequency ablation, to provide basis for patients' early postoperative rehabilitation.Methods:By convenient sampling method, a total of 120 patients with atrial fibrillation after radiofrequency ablation were collected at Yanghu Branch and City Branch of Changzhou Second People's Hospital from January 2020 to May 2021. They were divided into the early group, middle group and late group according to the random number table method, each group were 40 cases. All patients received routine postoperative intervention, the time of ambulation were 4, 6 and 12 h after operation in the early group, middle group and late group, respectively. The complication rate within 24 h after operation was compared among the three groups, and the comfort level of the three groups at 24, 48 and 72 h after operation was evaluated with Comfort Status Scale (GCQ).Results:Finally, 111 patients were included, including 37 in the early group, 38 in the middle group and 36 in the late group. There was no significant difference in the incidence of bleeding or hematoma, urinary retention, lumbago within 24 h after operation among the three groups ( P>0.05). The incidence of postural hypotension within 24 h after operation in the early group was 2.7% (1/37), which was lower than 21.1% (7/38) and 25.0% (9/36) in the middle and late groups, with a statistically significant difference ( χ2=4.86, 7.67, both P<0.05). At 48 and 72 h after operation, the scores of physiological dimension, psychological dimension and the total score of GCQ in the early group were (20.68 ± 3.07), (22.54 ± 3.35), (81.68 ± 6.11) and (22.54 ± 3.73), (24.38 ± 2.49), (84.92 ± 6.37), higher than those in the middle group (19.16 ± 2.19), (21.32 ± 2.27), (78.24 ± 5.58), (20.93 ± 2.85), (22.32 ± 2.04), (81.66 ± 6.56), and those in the late group (18.44 ± 1.50) (21.31 ± 1.99), (78.06 ± 4.32), (20.89 ± 2.25), (21.58 ± 1.86), (80.28 ± 6.44), the differences were statistically significant ( t values were 2.19-4.15, all P<0.05). Conclusions:Ambulation at 4 h after operation does not increase peripheral vascular complications, but can reduce the incidence of postural hypotension and improve the comfort of patients with atrial fibrillation after radiofrequency ablation.

OBJECTIVE To systematically introduce the supply guarantee system of orphan drugs in South Korea， and to provide reference for improving the accessibility of orphan drugs in China. METHODS The basic characteristics and practical experience of supply guarantee system of orphan drugs in South Korea were summarized by studying the marketing incentive mechanism， reserve supply mechanism and emergency use mechanism. Then， based on the research on the current situation and existing problems of orphan drug supply in China， specific suggestions were put forward to improve the accessibility of orphan drugs in China. RESULTS & CONCLUSIONS South Korea has effectively improved the accessibility of orphan drugs through orphan drug identification channels and supporting incentive policies， relying on the reserve supply mechanism and the import route for emergency use. Therefore， it is suggested that China should guarantee the normal supply of orphan drugs from three aspects： improving the recognition and incentive policy of orphan drugs， building a full-time management department of orphan drugs， and optimizing the temporary import path.