Objective To evaluate the efficacy and toxicity of anthracycline and taxane combination regimen in the treatment of advanced breast cancer in patients who were previously treated with anthracycline and taxane.Methods Twenty-six patients who previously failed to respond to anthracycline and taxane based chemotherapy received pemetrexed and tegafur combination regimen (pemetrexed:500 mg/m2,ivgtt on the first day; tegafur:80 mg/(m2 · d),twice daily during day 1-14).The regimen was repeated at least two cycles of three weeks each and the clinical response was recorded at two weeks after treatment.Results Of the 26 patients,he tumor control rate was 65.3％ (17/26),and the overall response rate was 46.2％ (12/26),including 3 patients with complete remission and 9 patients with partial remission.The symptoms were stable in 5 patients and improved in 9 patients.There was no severe complications or death observed.The most frequent treatment-related adverse events were myelosuppression,nausea,vomitting,rash and hepatic function impairment.Conclusion Pemetrexed combined with tegafur in the treatment of patients with advanced metastatic breast cancer who did not respond to anthracycline and taxane treatment is effective with minimal adverse reactions and can be tolerated by patients.

Objective To investigate the ideal method of repair ing the abdominal defect after the TRAM flap transfer. Methods 24 cases of the abdominal defect after TRAM flap transfer were repaired by a polypropypene mesh. The anterior rectus sheaths on the pedicle were directel y sutured. Results Using of polypropylene mesh not only r epaired the abdominal defect but also achieved a superior abdominal aesthetic re sult. No ″abdominal compartment syndrome″ and infection happened d uring the ho spitalization. Mean patient follow-up was 1 year. No abdominal hernia, bulge an d laxity were encountered. The result of the abdominoplasty was continuous and t he functions of the abdomen were good. Conclusions It is an ideal method that using of polypropylene meth repairs the defect of abdomen . It keeps the integrity and the functions of the abdomen, decreases the complica tions, and at the same time gets the abdominoplasty effect.

Objective: To investigate the willingness to pay integrated medical and elderly care services and identify the influencing factors among the elderly in Hohhot City, Inner Mongolia, so as to provide insights into promoting integrated medical and elderly care services. Methods: The elderly at ages of 60 years and older were sampled using a convenient sampling method from public venues in four districts of Huimin, Saihan, Yuquan and Xincheng in Hohhot City from June to December 2021. Basic characteristics, health and disease burdens, social support and willingness to pay integrated medical and elderly care services were collected, and factors affecting the willingness to pay integrated medical and elderly care services were identified among the elderly using a multiple linear regression model. Results: A total of 1 008 valid questionnaires were recovered, with an effective recovery rate of 96.74%. The respondents included 519 men (51.49%) and 489 women (48.51%), and had a mean age of (69.47±6.42) years. The monthly average fees of willingness to pay integrated medical and elderly care services were (2 076.49±36.79) Yuan, and there were 636 participants with 2 000 Yuan and less monthly average fees of willingness to pay integrated medical and elderly care services (63.10%). Multiple linear regression analysis showed that place of residence (β=180.832), satisfaction with housing (satisfied, β=-140.760), physical self-care ability (completely self-care: β=-238.244; mostly self-care: β=-254.557), burdens of disease diagnosis and treatment (able to afford: β=452.488; partly afford: β=228.626), monthly income (β=347.144), expenses of medications (β=0.019) and total score of social support (β=17.116) were factors affecting the willingness to pay integrated medical and elderly care services among the elderly. Conclusions The willingness to pay integrated medical and elderly care services among the elderly in Hohhot City is associated with place of residence, monthly income, satisfaction with housing, physical self-care ability, burden of disease diagnosis and treatment, expenses of medications and social support.

Cost-Benefit Analysis ; Early Detection of Cancer ; Humans ; Mass Screening ; methods ; Neoplasms ; diagnosis ; epidemiology ; therapy ; Program Evaluation

Objective To investigate the factors affecting the cosmetic results in the breast cancer treated with breast conservation to get the better cosmetic results.Methods Treated breasts were scored by the plastic surgeon and the patient independently.Mann-Whitney U test was used in univariate analyses whereas logistic regression was used in multivariate analyses.Results In the surgeon's evaluation, the satisfactory rate was 65.7 %.In univariate analyses,age(P=0.003),body mass index(BMI)(P=0.002),menopausal status(P=0.002),the radiation dose(P=0.022),the number of the incisions as the tumour was located in the outer-upper quadrant(P=0.036),the resection times(P=0.036),fibrosis(P=0.002),the type of surgery(P=0.002) were the significant factors affecting cosmetic results.In multivariate analyses,fibrosis,the type of surgery and the radiation dose(P=0.009,0.001,0.019) were the significant factors affecting cosmetic results.In the patient's evaluation,the satisfactory rate was 76.1%.In univariate analyses,the type of surgery (P=0.001) and fibrosis(P=0.045) were found to be significant factors. In multivariate analyses using logistic regression,the type of surgery(P=0.005) were the most significant factors.Conclusions The satisfactory rate has positive correlation between the surgeon and the patient.In the twenty-seven possible factors affecting the cosmetic results,age,body mass index,menopausal status,radiation dose,the number of the incisions as the tumour located in the outer-upper quadrant,the resection times,fibrosis and the type of surgery are the main factors affecting the cosmetic results significantly.

Objective To observe the effect of Oxycontin combined with Gabapentin for treatment of malignant neuropathic pain.Methods Sixty-three cases of malignant neuropathic pain in Jinshan Hospital Affiliated to Fudan University were randomly divided into group A, B and C.Patients of which were given Oxycontin, Gabapentin, Oxycontin combined with Gabapentin respectively for pain treatment.The analgesic effects, toxic reaction side effects, quality of life, and immune function were all compared in three groups.Results Compared with pretherapy, the cancer pain score (NRS), quality of life (QOL) and karnofsky performance status(KPS) scores in all groups were changed significantly after drugs therapy(F=375.852,154.612, 151.838,P＜0.05).The levels of CD3,CD4, CD4/CD8 and NK cells in all groups were higher than before therapy(F=158.935,108.145,366.973,92.090,P＜0.05).After treatment,the NRS, QOL and KPS scores in group C were 2.00± 0.86,44.80± 6.07, 84.50± 6.05, in group A were 3.35 ± 0.67,37.35 ± 5.71,74.50 ±10.99,and in group B were 4.05±0.94,35.85±5.90,72.00±8.34, and the different were significant (F =3.250,10.499,3.465,P＜0.05).The levels of CD3, CD4, CD4/CD8and NK cells in group C were (72.94 ±5.63)％,(41.52±4.19)％, 1.86±0.30, (27.57±6.86)％,in group A were (62.84±5.27)％, (33.84 ±5.40)％,1.35±0.37, (20.49±6.67) ％,and in group B were (62.22±8.10)％, (33.19±6.90)％, 1.32 ± ±0.41, (20.32±5.63) ％, and the different were significant (F =3.377,3.344,3.352,3.386, P＜ 0.05).The patient in group C had less adverse effects than those in group A and B.Conclusion Oxycontin and Gabapentin in treatment of malignant neuropathic pain is effective.

Objective: To investigate the incidence of road traffic injuries among online deliverymen and its influencing factors, so as to provide insights into prevention of road traffic injuries. Methods: Online deliverymen who were registered on a takeaway platform and delivered within Baotou City, Inner Mongolia Autonomous Region were recruited using a convenience sampling method, and demographic information, delivery work conditions and road traffic injury data were collected through questionnaire surveys from June to September, 2023. Factors affecting the incidence of road traffic injuries were identified by a multivariable logistic regression model. Results: A total of 603 questionnaires were allocated, and 584 were valid, with an effective rate of 96.85%. There were 467 men (79.97%) and 117 women (20.03%), 200 participants at ages of 31-40 years (34.25%), 215 crowdsourcing deliverymen (36.82%) and 510 full-time (87.33%). The incidence of road traffic injuries in the past one year was 14.90%, and 59 injuries were mild (67.82%). The parts of injuries were mainly upper limbs (31.03%) and lower limbs (45.98%). Multivariable logistic regression analysis showed that online deliverymen who did not wear a helmet at work (OR=2.591, 95%CI: 1.354-4.958) and worked as a crowdsourcing deliverymen (OR=2.232, 95%CI: 1.041-4.786) had higher risks of road traffic injuries, while online deliverymen who worked part-time (OR=0.154, 95%CI: 0.034-0.706) had lower risks of road traffic injuries. Conclusions The incidence of road traffic injuries among online deliverymen is associated with post, type of work and wearing helmets or not. The traffic safety education and management should be strengthened among online deliverymen.

AIM: To explore whether AT2 receptor is expressed in skeletal muscular vasculature, and the expression of angiotensin Ⅱ receptors in pulmonary circulation of children with left-to-right shunt but without obstructive pulmonary hypertension. METHODS: Lung and skeletal muscular tissue were obtained from 20 children with left-to-right shunt by biopsy during operation. These skeletal muscular tissues were detected by reverse transcriptase/polymerase chain reaction (RT-PCR ) and immunohistochemistry techniques for AT2 receptors. mRNA of AT1 and AT2 receptors in lung tissues were detected by RT-PCR and analyzed semi-quantitatively. RESULTS: In all of the skeletal muscular tissues, mRNA of AT2 receptor was found by RT-PCR, and the results of immunohistochemistry staining for AT2 receptor of vessels were positive. In the lung tissues, the level of mRNA of AT2 receptor was different to AT1 receptor, and the former was higher than the latter (P

Objective To explore the early diagnosis and risk factors for judging prognosis of acute respiratory distress syndrome (ARDS),and to provide references for clinical intervention.Methods Using the method for prospective cohort study,clinical data were collected from 64 ARDS and 66 high-risk ARDS patients in Department of Respiratory Diseases of Xinqiao Hospital from January 2013 to March 2016.They included patients' demographic data,Acute Physiology and Chronic Health Evaluation system Ⅱ (APACHE Ⅱ) score,oxygenation index,blood routine test,coagulation function and inflammatory markers (procalcitonin,C-reaction protein,tumor necrosis factor and interleukin-6) within 24h and the state of survival or death of the 24th day.Risk factors for predicting progression of the high-risk ARDS patients into ARDS patients and influencing the prognosis of the ARDS patients were analyzed by using logistic regression.Results Univariate logistic regression analysis found that the independent risk factors for progression of ARDS were APACHE Ⅱ score (OR=6.764,P=0.001),hypoproteinemia (OR=10.54,P=0.002),white blood cell count (OR=3.912,P=0.012),fibrinogen (OR=9.953,P=0.064),and D-dimer (OR=4.239,P=0.029).The mortality rate was 43.75％ (36/64) in ARDS group,and the oxygenation index (OR=6.573,P=0.014),platelet count (OR=9.376,P=0.003),hypoproteinemia (OR=10.738,P=0.056) were the independent risk factors of death in ARDS patients.Multivariate logistic regression showed that combination of multiple indicators for predicting ARDS improved the specificity,but reduce the sensitivity.APACHE Ⅱ and hypoproteinemia (sensitivity 62.50％,specificity 92.42％) and APACHE Ⅱ and D dimmer (sensitivity 62.07％,specificity 93.33％) had better specificity and sensitivity.The specificity and sensitivity of combining hypoproteinemia and platelet count to predict the risk of death in these patients were 77.78％ and 60.71％.Conclusions In high-risk ARDS patients,combining hypoproteinemia or APACHE Ⅱ score with D-dimer to judge the development of ARDS has good specificity but poor sensitivity.For ARDS patients,low oxygenation index,thrombocytopenia and hypoproteinemia indicate a poor prognosis.

Objective To study the effect of preconditioning hyperbaric oxygenation on skin flap is-ehaemia tolerance. Methods 18 male SD rats were divided into the control and HBO preconditioning groups. In control group, an extended epigastrie adipocutaneous flap was raised, based on the right su-perficial epigastric artery and vein. 3-hours flap ischemia was induced by clamping the pedicle vessels with microvascular clamp. At the end of ischemia induction, the clamp was removed and the flap was sutured back. Rats in HBO preconditioning group were treated with HBO two days before operation. Flap surger-y began 1 hour after the last HBO treatment. The operation was the same as the control group. On the fifth postoperative day, the condition of the flap was recorded with transparent paper. Mean flap necrosis area was calculated with Acrobat software. Data were analyzed with SPSS software. Results The aver-age designed flap area was (51.59±6.62)cm2 and (52.71±2.05)cm2 in the control group and the HBO preconditioning group. The average flap survival area was (7.38±2.49)cm2 and (15.82±5.95)cm2. The difference was significant between the control and HBO preconditioning groups (t= 4. 14, P<0.01) in average flap survival area. Conclusion HBO preconditioning can rise flap ischaemia tolerance and enhance flap survival.