Objective To observe ultrasonic and PET/CT features of malignant lymphoma after chemotherapy and to determine the value in assessment of lymphoma treatment response.Methods Seventy-seven lymph nodes in 32 patients were observed and measured with color Doppler ultrasound and PET/CT after chemotherapy comparing with pathologic results.Results Seventy-two lymph nodes were exactly certified by ultrasound(94.8%),and seventy-five nodes were exactly confirmed by PET/CT(97.4%).There were significant differences in L/S,blood supply type,Vmax,Vmin,RI(P＜0.05)between nodes groups with and without residual tumor.The PET/CT inspection demonstrates that lymph nodes with residual tumor was in the high metabolism condition.The positive nodes'index of ultrasound were connected with their metabolism condition.Conclusions The two methods all have high rate of accuracy.Ultrasound can be used as normal method in assessment of lymphoma treatment response.

This study is to establish a method for simultaneously determination of five nucleosides and nucleobases, including hypoxanthine, uridine, adenine, guanosine and adenosine in Rehmannia glutinosa Libosch. which was collected from different regions in China. A Diamonsil C18 column (250 mm x 4.6 mm, 5 microm) was used. Acetonitrile and 0.04 mol L(-1) potassium dihydrogen phosphate solution were adopted as mobile phase with gradient elution. The flow rate was 1 mL min(-1) and column temperature was 30 degrees C. The detection wavelength was at 254 nm. The method had good linearity over the range of 1.0 - 16.0 microg mL(-1) (r2 = 0.999 8), 5.0 - 80.0 microg mL(-1) (r2 = 0.999 8), 1.0 - 16.0 microg mL(-1) (r2 = 0.999 5), 1.25 - 20.0 microg mL(-1) (r2 = 0.999 8) and 1.0 - 16.0 microg mL(-1) (r2 = 0.999 8) for hypoxanthine, uridine, adenine, guanosine and adenosine, respectively. The average recoveries were between 98.8% and 100.7%. The content of hypoxanthine, uridine, adenine, guanosine and adenosine in Rehmannia glutinosa Libosch. from different regions was significantly different. This established method was sensitive and reliable for the quantification of five chemical constituents in Rehmannia glutinosa Libosch.

This study aims to investigate the current situation of the enrollment , training model and career planning of medical students in the targeted admission program .After analyzing the implementation process of this targeted admission policy in medical education , we raised some feasible strategies to increase the attraction and reten-tion of health professionals in rural China .The study covered 4 medical universities in central and western China .A cohort of 308 medical graduates from this targeted admission program were recruited in June 2015 .A baseline survey , including questionnaire survey , in-depth interviews and the focus group discussions , were conducted right before their graduation .The first follow-up online survey was done 6 months after their graduation .he findings of this investiga-tion show that 72.9%of the investigated students in the program used to live in rural areas before 15 years old.The average annual household income was 28,200 Yuan.The top three reasons of choosing this program were guaranteed job after graduation , low performance in the college entrance examination , and wavier of tuition fee .There were sig-nificant differences of implementation of this policy between different provinces , especially the contract-signing and job deployment .Income and working environment were the main influencing factors of the medical graduates 'job-see-king intention .Based on the findings of this study , it can be concluded that the targeted admission program is rather successful in attracting medical graduates for rural health services .However , extra efforts are needed to improve the implementation of the policy and to retain the medical graduates in rural area .

Objective: In order to describe the employment status of the first group of targeted admission medical graduates, evaluate the effects of targeted admission medical education program, find out the existing problems and provide relevant policy recommendations.Methods: This study conducted follow-up survey among 305 medical graduates and 315 clinical medical graduates in four medical colleges of the central and western regions.Data analyses of the contract fulfillment, their employment status, and their participation in the standardized residency training are carried out.Results: The contract fulfillment rate of rural-oriented medical graduates is 99.3%, while the percentages of rural-oriented medical graduates and clinical medical graduates are 90.7% and 2.8%, respectively.Their average monthly incomes are respectively 2,011 and 2,774 yuan, and their proportions of participating in standardized residency training are 77.8% and 43.3% respectively.From the findings it can be seen that the employment situation of the first group of targeted admission medical graduates in four medical colleges and universities is quite good, but the policy implementation process in terms of permanent post and income is less satisfactory.However, the way how medical graduates should participate in the standardized residency training is not yet clearly regulated.This paper recommends that medical colleges and universities should well coordinate with local health administrative departments and human resources and social security departments to systematically deploy medical graduates.At the same time, full consultations should be conducted to make appropriate arrangement for medical graduates to participate in standardized residency training.

To investigate the effects of three classical anti-jaundice formulas Yinchenhao Decoction (YCHD). Yinchen Wuling San (YCWLS) and Zhizi Baipi Decoction (ZZBPD) on liver fibrosis induced by dimethylnitrosamine (DMN) in rats and explore the formula-syndrome relationship.

Objective:Understand the status of brushing teeth behavior of preschoolers in Shaanxi Province, to provide basis for oral health of preschoolers.Methods:By adopting the methods of multi-stage, stratified, geometric and cluster sampling, 1 370 kindergarten students at the age of 3-5 in Shaanxi Province were sampled as respondents to implement oral health questionnaire.Results:49.2%(674/1 370) children brushed their teeth every day, including only 14.8%(203/1 370) children brushing their teeth twice or above. Therefore, the difference of the brushing frequency (≥ 1 time/day) between urban and rural areas had obvious statistical significance ( χ2 value was 47.588, P<0.01). 98.7%(741/750) children used toothpaste, including only 6.9% (51/741) using toothpaste with fluoride. Therefore, the use of toothpaste between urban and rural areas has no statistical significance. Only 0.5% (4/751) children started to brush their teeth when their first deciduous tooth erupted. Therefore, the age for children starting to brush their teeth between urban and rural areas had obvious statistical significance ( χ2 value was 24.217, P<0.01). 65.2% (490/751)parents never helped their children to brush teeth, parents in rural areas even reached to 72.8% (227/312). Therefore, the brushing frequency for parents helping their children to brush teeth between urban and rural areas had statistical difference ( χ2 value was 16.192, P<0.01). Conclusions:The status of brushing teeth behavior of preschoolers in Shaanxi Province is lower than the national level, and the level in rural areas is obviously lower that in urban areas. The education and cultivation on brushing teeth behavior should be further strengthened in the future propaganda and education, especially, the power of propaganda on children and parents in rural areas should be strengthened.

In recent years, with the continuous development of glucagon-like peptide-1 receptor agonists(GLP-1RA), its role in the management of blood glucose in hospitalized patients has been explored. GLP-1RA can not only control blood glucose in non-critically ill hospitalized patients, but also inhibit appetite, delay gastric emptying, protect nerves, anti-inflammation, reduce systolic blood pressure and blood lipids. At the same time, many studies have found that it can also improve cardiovascular and renal outcomes and reduce the risk of hospitalization complications. Therefore, this paper analyzes the role of GLP-1RA in glycemic management by reviewing domestic and international studies, consensus and guidelines related to inpatient blood glucose management, and helps to better manage blood glucose of patients in non-critical care setting.

Objective:To investigate the association between CITP/MMP-1 ratio and the severity of Myocardial fibrosis (MF) in patients with Chronic Heart failure (CHF) and its diagnostic and prognostic value in patients with MF.Methods:A retrospective study was conducted to select 110 cases [86 males, (56.60±11.15) years old;24 females, (60.06±12.02) years old] who were hospitalized in the Department of Cardiology, Teda International Cardiovascular Hospital from May 18, 2021 to February 30, 2022 and underwent magnetic magnetic examination. Serum CITP and MMP-1 were detected by enzyme-linked immunoassay and CITP/MMP-1 ratio was calculated. Plasma brain natriuretic peptide (BNP) was detected by automatic chemiluminescence analyzer. Anova and non-parametric test were used to compare the difference of indexes among all groups. Spearman analysis was used to analyze the correlation between serum collagen metabolites and the severity of myocardial fibrosis. Logistic regression analysis was performed for multivariate analysis, and ROC curve was used to evaluate the auxiliary diagnostic value of related indexes. Major adverse cardiac events within 1 year after discharge were recorded, including cardiogenic death, HF rehospitalization, malignant arrhythmia, and myocardial infarction. The risk factors of poor prognosis were analyzed by Cox regression. Patients were divided by the median value of CITP/MMP-1 ratio or the median value of CITP/MMP-1 ratio and BNP. Survival analysis was performed by Kaplan-Meier and Log Rank test was performed.Results:Serum MMP-1 and BNP in LGE (+) group were higher than those in LGE (-) group (1.79 ng/ml > 0.91 ng/ml, Z=-2.924; 503 pg/ml > 367 pg/ml, Z=-1.932; P<0.05); The CITP/MMP-1 ratio in the LGE (+) group was lower than that in the LGE (-) group (3.84 < 10.85, Z=-3.601, P<0.001). MMP-1 in CHF with arrhythmia group was higher than that in CHF group (1.98 ng/ml > 1.25 ng/ml, Z=-2.016), while CITP/MMP-1 ratio was lower than that in CHF group (3.25 < 5.73, Z=-2.751), all P<0.05. CITP/MMP-1 ratio in CHF patients was negatively correlated with the severity of MF ( r=-0.363, P<0.001), and BNP and MMP-1 were positively correlated with the severity of MF ( r=0.267, r=0.264, P<0.05). Serum BNP was positively correlated with collagen metabolite MMP-1 and negatively correlated with CITP/MMP-1 ratio (all P<0.05). Logistic multivariate regression analysis showed that only CITP/MMP-1 was a predictor of myocardial fibrosis, with an OR value of 0.624 ( P=0.005). ROC curve was used to evaluate serum BNP, MMP-1 and CITP/MMP-1 ratio in the diagnosis of myocardial fibrosis in HF patients, with AUC of 0.653, 0.696 and 0.754, respectively. The accuracy of CITP/MMP-1 ratio in diagnosing fibrosis was better than that of BNP by comparing their AUC, and the difference was statistically significant ( Z=-3.808, P<0.001). Cox regression analysis showed that CITP/MMP-1 ≤3.84 was a risk factor for poor prognosis, OR=2.647 ( P=0.009). Kaplan-Meier survival analysis at 1-year follow-up showed that the survival rate of the group with lower CITP/MMP-1 ratio was significantly lower than that of the group with higher CITP/MMP-1 ratio ( P=0.014). The survival rate of CITP/MMP-1 increased and BNP decreased group was higher than that of CITP/MMP-1 decreased and BNP increased group ( P=0.011). Conclusions:The ratio of CITP/MMP-1 can be used as a negative correlation indicator of the degree of cross-linking, which is better than BNP in the evaluation of MF, and has a good auxiliary diagnostic value for myocardial fibrosis in patients with chronic heart failure, and is expected to become a protective indicator for patients with chronic heart failure and be used in clinical evaluation of myocardial fibrosis. CITP/MMP-1 ratio is associated with the incidence of major adverse cardiac events, and CITP/MMP-1 ≤3.84 can be used as a predictor of prognostic adverse cardiovascular events in CHF patients.

OBJECTIVE: To investigate the metastatic rule and management methods of occult lymphatic metastasis in patients with supraglottic cancer. METHOD: The results of 139 cN0 patients with supraglottic cancer treated by neck dissection (ND) were reviewed retrospectively. Each lymph node was studied pathologically in order to define the level of the lymph node metastasis. RESULT: Of the 139 patients with supraglottic cancer and cN0 neck, 113 cases received ipsilateral ND and 26 cases with bilateral ND. Thirty-six (25.9%) of 139 patients were found to have occult lymphatic metastasis on pathological examination, 6 patients without metastasis in dissected side at pathologic examination showed metastasis in the contralateral undissected neck later. Therefore the total occult metastasis rate was 30.2% (42 of 139). The unilateral and bilateral neck occult metastases were determined in 37 cases (26.6%) and 5 cases (3.6%) respectively. A total of 3594 lymph nodes were harvested in 165 specimens, with 83 positive nodes. The distributions of the 83 positive nodes were as follows: level I 1.2% (1 node), level II 78.3% (65 nodes), level III 19.3% (16 nodes), level IV 1.2% (1 node), level V (0 node). The 3-year regional recurrence rate was 5.0% (7/139). The 5-year survival rate was 76.3% (106/139). Patients with positive neck metastasis had higher regional recurrence rates (P < 0.05). CONCLUSION Occult metastasis rate of supraglottic cancer is as high as 30.2%, the selective lateral neck dissection of level II, III is recommended.
Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; Female ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Neoplasm Staging ; Retrospective Studies

Objective:To investigate the efficacy of 3D-printed quantitative bone implants assisting second-stage Masquelet technique for the treatment of long-segment bone defect following Gustilo type IIIB and IIIC tibial fractures.Methods:A retrospective case series analysis was made on 26 patients with long-segment bone defect following Gustilo type IIIB and IIIC tibial fractures treated in Wuxi Ninth People′s Hospital from July 2015 to December 2020, including 20 males and 6 females; aged 19-63 years [(46.5±4.5)years]. Gustilo classification was type IIIB in 23 patients and type IIIC in 3. In the first stage, all patients had thoroughly emergent debridement, removal of all free bone pieces, restoration of the length and force line plus externally fixion, and vacuum sealing drainage (VSD) of the residual wound. After 2-7 days, the external fixation was removed and replaced by internal fixation, with the bone cement filling in the defect area and the free flap covering the wound. The length of tibial bone defect was 5-14 cm [(6.3±0.4)cm], and the tibial defect volume was 12.2-73.1 cm 3 [(33.6±9.2)cm 3]. In the second stage (6-19 weeks after injury), the bone cement was removed, followed by autologous bone grafting. Prior to bone grafting, digital technology was used to accurately calculate the bone defect volume, and an equal volume of bone harvesting area was designe to produce the 3D printed osteotomy template. Bone grafting was conducted after bone removal according to the osteotomy template during operation. The success rate of one-time iliac bone extraction, bone harvesting time, and bleeding volume were recorded. Pain in the bone extraction area was evaluated by visual analogue score (VAS) at 1 day and 1 month after operation and at the last follow-up. Wound healing, complications, and bone healing were observed. Life quality was evaluated by health survey brief form (SF-36) including scores of physical component summary (PCS) and mental component summary (MCS) before bone grafting and at the last follow-up. Results:All the patients were followed up for 13-53 months [(32.3±12.5)months]. One-time iliac bone extraction was successful in all the patients. Bone harvesting time was 15-30 minutes [(21.0±2.5)minutes]. The bleeding volume was 50-120 ml [(62.3±29.0)ml]. The VAS was 1-4 points [(1.2±0.9)points] at 1 day after operation, higher than these (0.0±0.0)points at 1 month after operation and at the last follow-up (all P<0.01). Totally, 25 patients obtained wound healing after operation, except for 1 patient with superficial wound infection after bone grafting that was healed by dressing change. There was 1 patient with bone infection after 3 months of bone grafting that was healed by repeated surgery with Masquelet technique in the first and second stage. Besides, 2 patients had symptoms of cutaneous nerve injury in the iliac donor area. The time of bone healing was 4-7 months [(5.8±0.8)months]. The scores of PCS and MCS in SF-36 at the last follow-up were (73.6±12.8)points and (83.6±13.2)points, significantly higher than those before bone grafting [(46.8±0.5)points, (60.7±2.0)points] (all P<0.01). Conclusion:Second-stage Masquelet technique with 3D printed quantitative bone implants for the treatment of long-segment bone defect following Gustilo type IIIB and IIIC tibial fractures is associated with shortened bone harvesting time, attenuated pain, reduced complications, accelerated bone healing and improved function.