Objective To investigate the feasibility and efficacy of the intensity modulated radiotherapy (IMRT) with oral S-1 for locally advanced pancreatic cancer.Methods Forty-two patients with locally advanced pancreatic cancer were selected,and the patients were divided into 2 groups by random digits table method with 21 cases each.The patients in treatment group were treated by IMRT combined with oral S-1 40 mg/m2 twice daily from day 1 to day 14 of a 21-d cycle;the patients in control group were treated by IMRT combined with 30 min intravenous infusions of gemcitabine 1 000 mg/m2 on day 1,8,21 and 29.Radiation was concurrently delivered at a dose of 50.4 Gy (1.8 Gy/d,5 times per week,28 fractions).The dose of intensity modulated radiotherapy was 1.8 Gy/time (5 times/week,50.4 Gy/28 times).The recent curative effect and untoward reaction were assessed at the end of radiotherapy after 4 weeks.Results There were no statistical differences in efficient rate and disease control rate between treatment group and control group:57.1％ (12/21) vs.47.6％ (10/21) and 85.7％ (18/21) vs.76.2％ (16/21),P ＞ 0.05.The neutropenia rate and thrombocytopenia rate in treatment were significantly lower than those in control group:23.8％ (5/21) vs.57.1％ (12/21) and 28.6％ (6/21) vs.66.7％ (14/21),and there were statistical differences (P ＜ 0.05).There were no statistical differences in the incidences of anemia,nausea,vomiting,elevated aminotransferase and fatigue (P＞ 0.05).Conclusions The IMRT with oral S-1 for locally advanced pancreatic cancer is safe and effective.It is worthy of clinical promotion.

ObjectiveTo investigate the effect of anti-liver fibrosis Chinese patent drugs on renal hypofunction associated with alcoholic liver disease (ALD). MethodsA retrospective analysis was performed for 592 patients with ALD who were admitted to Beijing Ditan Hospital, Capital Medical University, from August 1, 2008 to March 1, 2016, and according to whether they were treated with Fuzheng Huayu capsules, Anluo Huaxian pills, or Fufang Biejia Ruangan tablets for ≥180 cumulative defined daily doses, they were divided into Chinese medicine group and control group. After propensity score matching at a ratio of 1∶1, two groups were obtained with 187 patients in each group. Related data were recorded, including medical history, drinking amount, routine blood test results, liver and renal function, coagulation, and abdominal imaging findings. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; the Kaplan-Meier method was used to compare the cumulative incidence rate of renal hypofunction between two groups. ResultsThere were no significant differences between the two groups in age, drinking amount, proportion of patients with hypertension or diabetes, baseline aspartate aminotransferase, estimated glomerular filtration rate, uric acid, and prothrombin time, and the patients were followed up for 36 months (range 23-54 months). Uric acid (hazard ratio ［HR］=1.003, 95% confidence interval ［CI］: 1001-1.005, P=0.001), prothrombin time (HR=1.103, 95%CI: 1.034-1.177, P=0.003), and red cell volume distribution width (HR=1.024, 95%CI: 1.011-1.038, P＜0.001) were independent risk factors for renal hypofunction in patients with ALD, and anti-liver fibrosis Chinese patent drug was an independent protective factor against renal hypofunction (HR=0.170, 95%CI: 0.053-0552, P=0.003). The Chinese medicine group had a significantly lower incidence rate of renal hypofunction than the control group (166% vs 32.1%, χ2=10.263, P=0.001). The subgroup analysis of the patients in the Chinese medicine group showed that Chinese medicine treatment for ＞24 months had the best effect (HR=0.210, 95%CI: 0.084-0.525, P=0.001). Compared with the control group, the Chinese medicine group had a significantly longer time to the onset of renal hypofunction (36 months vs 24 months, Z=-2.652, P=0.008). ConclusionAnti-liver fibrosis Chinese patent drugs can reduce the incidence rate and delay the onset of renal hypofunction in patients with ALD.

Objective To investigate the relationship between serum fatty acid binding protein(FABP)1,FABP2 and diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2DM)and its diagnostic value.Methods A total of 170 patients with T2DM diagnosed and treated in this hospital from January 2020 to December 2022 were selected as the research objects.According to urinary albumin to creatinine ratio(UACR),they were divided into non-DKD group(UACR<30 mg/g,72 cases)and DKD group(UACR≥30 mg/g,98 cases).A total of 60 healthy people in the same hospital during the same period were selected as the control group.Pearson correlation analysis was used to analyze the correlation between serum FABP1,FABP2 and renal function related indicators.Multivariate Logistic regression was used to analyze the influencing fac-tors of DKD.Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of serum FABP1 and FABP2 for DKD.Results The DKD group had significantly higher serum levels of FABP1 and FABP2 than the non-DKD group and the control group(P<0.05),and the non-DKD group had significantly higher serum levels of FABP1 and FABP2 than the control group(P<0.05).Compared with the non-DKD group,the DKD group had a significantly lower eGFR and significantly higher UACR,serum creatinine,blood urea nitrogen,and serum uric acid levels(P<0.05).Serum FABP1 and FABP2 levels were positively correla-ted with UACR,serum creatinine,blood urea nitrogen,and negatively correlated with eGFR(P<0.05).In-creased serum FABP1 and FABP2 levels were independent risk factors for DKD.The serum FABP1,FABP2 joint detection diagnosis efficiency was better than that of serum FABP1,FABP2 detection alone(Z=4.712,4.363,P=0.001,0.002).Conclusion The serum levels of FABP1 and FABP2 are increased in patients with DKD,and they are related to the degree of renal function damage,which are independent risk factors for the occurrence of DKD in patients with T2DM.The combined detection of FABP1 and FABP2 has a high diagnos-tic efficiency for the occurrence of DKD in patients with T2DM.

Objective: To investigate and analyze the clinical teaching of residents standardized training in Zhejiang University, so as to provide references to improve the quality of residents standardized training. Methods: Questionnaires were designed and electronic surveys via WJX software were conducted among residents from six affiliated hospitals of Zhejiang University School of Medicine on management, clinical teaching and assessment of residents. SPSS 19.0 was used to perform the χ² test of relevant data. Results: A total of 799 residents, including 312 males and 487 females, took part in this survey. In terms of satisfaction degree, trained residents had a relatively high satisfaction degree on training base (73.46%), satisfaction degrees of residents from Grade one, two and three were 69.05%, 74.72% and 79.30%, respectively. Satisfaction degree of residents with different identities to training base was social men (85.71%) > staff working in units (74.08%) > professional postgraduates (56.7%). In terms of teaching, 64.45% residents thought that clinical teachers spent 20% more time on the clinical teaching than on the daily routine work, 39.42% residents thought that clinical teachers spent 30% more and 18.52% residents thought clinical teachers spent 40% more. In addition, 70.47% residents responded that their teachers revised and instructed the medical history writing more than twice a week; 78.84% trained residents admitted that all teachers made full preparations for clinical teaching rounds. Besides, the process evaluation of training base was well implemented. Implementation rate of after-department examination and annual examination were 99.37% and 98.50%, respectively. Conclusion Residents of Zhejiang University have a high satisfaction degree on training management and clinical teaching. Homogenized management of training base should be strengthened, and evaluation and feedback should be stressed.