Objective To observe the effect of tropisetron and tranquilizer on preventing nausea and vomiting induced by breast cancer chemotherapy,in comparison with using only tropisetron.Methods 78 cases of breast cancer patients undergoing chemotherapy were randomly divided into the observation group (40 cases) and the control group (38 cases).The observation group used the method of antiemetic intravenous tropisetron,while the control group adopted intravenous drip of tropisetron combined with intramuscular injection of chlorpromazine.The incidence of nausea and vomiting of two groups was observed.Results The incidence of nausea and vomiting of the observation group was higher than that of the control group.The incidence of adverse reaction showed no obvious difference between two groups.Conclusions Intravenous injection of tropisetron combined with intramuscular injection of chlorpromazine can reduce nausea and vomiting caused by chemotherapy of breast cancer,so this method is worthy of popularization.

Objective To evaluate the clinical significance of multi - tumor markers combined detection in patients with idiopathic pulmonary fibrosis. Methods The serum levels of alpha fetoprotein (AFP) , careinoembryonic antigen (CEA), cancer antigen 125 (CA125) ,carbohydrate antigen 153(CA153) .carbohydrate antigen 199(CA199) were determined in 27 patients of idiopathic pulmonary fibrosis and 24 healthy volunteers. At the same time,the clinical indicators, such as lung function,were also measured in 27 patients. Results In comparison to control group, the serum levels of AFP, CEA,CA125 , CA153, CA199 were obviously lower than those in control group(P0.05). Conclusion Tumor markers,CA199 in particular,reflect the severity and poor prognosis of IPF patients and may also indicate the progression of pulmonary fibrosis, but they have nothing to do with disease activity.

Objective To investigate the relationship between the ultrasonography diagnosis in prenatal and the postnatal placental vascular casts of the twins reversed arterial perfusion(TRAP) sequence. Methods Six cases of TRAP sequence underwent the two-dimensional and color Doppler ultrasonography, and performed placental vascular casts after termination of pregnance. Results According to the anatomical features and ultrasonography, there were 3 cases of acardius acephalus( IV) ,2 cases of acardius anceps( II ) , and 1 case of acardius acormus( I ). In all 6 cases,there were arterio-arterial and veno-venous anastomoses at the level of the chorionic plate between the normal co-twin and the acardiac twin,these anastmosis vessels were superficial and large calibre, and the distances of the placental insertions of the umbilical cords were different,4 cases <0. 5 cm, 2 cases were 4-5 cm. In 4 cases, the vessels entered and went out of the acardiac twin were just one large umbilical artery and one large umbilical vein. In 2 cases, the umbilical artery and umbilical vein had many vascular branches in the placenta. Out of 6 cases of the pump twin, 4 cases died,and 2 cases survived. Conclusions Ultrasonography was consistent with the placental vascular casts,the contrast observing gives us new information for the further research of the special type of the vascular anastmosis and prognosis of the TRAP sequence.

Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P < 0.05), while menstrual cycle, family history of breast cancer and molecular typing showed no difference (P > 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P < 0.05), but there was no significant difference between different level of HER2 (P >0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.

Objective To investigate diagnostic efficiency of vascular parameters in the diagnosis of BI-RADS Ⅳ breast masses using three-dimensional power Doppler ultrasound (3D-PDUS).Methods After adjusting the ultrasonic instrument under property conditions,3D-PDUS were applied to scan BI-RADS Ⅳ breast masses before surgery with QLab software,the following parameters of breast masses were obtained:total tumor volume,vascularization index (VI),flow index (FI),and vascularization flow index (VFI).According to the pathological results,the diagnostic value of vascular parameters from 3D-PDUS were assessed with receiver operating characteristic (ROC) curve,and the diagnostic efficiency were analyzed by best cut-off limits of various vascular parameters.Results The volume and vascular parameters of benign group were remarkably lower than those of malignant group (all P ＜0.001).The area under the ROC curve (AUC) of VI (0.873) ＞VFI (0.866) ＞FI (0.778).AUC of FI was significantly smaller than that of VI (P =0.016) and of VFI (P =0.039),while no statistical difference between that of VI and of VFI (P =0.294).The diagnostic accuracies of VI (cut-point:1.2,sensitivity:84.1％,specificity:83.3 ％,accuracy:83.8 ％) and of VFI (cut-point:0.5,sensitivity:82.5 ％,specificity:85.2％,accuracy:82.9％) were higher than that of FI (cut-point:35.3,sensitivity:74.6％,specificity:70.4 ％,accuracy:72.6 ％).AUC of VI (P =0.001) and of VFI (P =0.033) in small-volume group (＜2cm3) were both larger than those of large-volume group (≥2 cm3),no significant difference in AUC of FI between these two groups (P =0.09).Conclusions Vascular parameters obtained using 3D-PDUS have affirmative value in the diagnosis of BI-RADS Ⅳ breast masses,especially in masses less than 2 cm3 in volume.

Objective To study the role of different dose nicorandil in prevention of CIN in elderly CHD patients.Methods One hundred and twenty-one elderly CHD patients were divided into standard dose nicorandil treatment group (n=42),5 mg nicorandil treatment group (n=39) and 10 mg nicorandil treatment group (n=40).Their Scr levels,and eGFR were measured for 3 days before and after PCI.The urine KIM-1 and NGAL levels were measured before and 24 h after PCI.The incidence of CIN and adverse reactions were compared in 3 groups.Results The incidence of (IN and the eGFR ≥25％ were significantly lower,the serum Scr level was significantly lower while the eGFR was significantly higher in 5 mg and 10 mg nicorandil treatment groups than in standard dose nicorandil treatment group on days 1 and 2 after PCI (P＜0.05,P＜0.01).The serum Scr level was significantly lower while the eGFR was significantly higher in 10 mg nicorandil treatment group than in 5 mg nicorandil treatment group on day 2 after PCI (P＜0.05).The urine KIM-1 and NGAL level were significantly lower in 10 mg nicorandil treatment group than in standard dose nicorandil treatment group and 5 mg nicorandil treatment group at 24 h after PCI (2.77±0.33 μg/L vs 5.63±0.27 μg/L,4.82±0.32 μg/L,P＜0.05;41.64±8.42 μg/L vs 66.51±10.72 μg/L,57.11±9.67 μg/L,P＜0.05).Conclusion Different oral doses of nicorandil play a role in prevention of CIN and 10 mg nicorandil plays a greater role than standard dose nicorandil and 5 mg nicorandil in prevention of CIN in elderly CHD patients undergoing PCI.

Objective: To evaluate the therapeutic effect and security of Buyang Huanwu decoction in treatment of the ischemic stroke recovery. Methods: We retrieved the relevant articles of random and semi- random control trials in treating ischemic stroke recovery using Buyang Huanwu decoction, published in China National Knowledge Infrastructure (CNKI), the Wanfang Data, the Weipu Information Resources System, the Chinese Biomedical Literature Database (CBM), Cochrane Library, PUBMED and MEDLINE from the date of establishment until to March 2018. The quality of studies was evaluated according to the Cochrane Reviewers?? handbook 5.1, and the study was carried out using Cochrane system assessment methods. Statistical analysis was performed with Rev Man 5.3. Results: Altogether 39 studies and 3539 cases of ischemic stroke recovery were enrolled. In terms of clinical efficacy, the difference between Buyang Huanwu Decoction and Western Medicine conventional therapy in the treatment of ischemic stroke was significantly different from that of conventional western medicine therapy [RR =1.26, 95％CI (1.20, 1.31), Z =10.05, P ＜ 0.00001], and the difference between Buyang Huanwu Decoction and other Chinese patent medicines was statistically significant [RR =1.12, 95％CI(1.06, 1.19), Z =3.82, P =0.0001]; neurological deficit NIHSS score [MD =-2.55, 95％CI (-3.10, -2.01), Z =9.20, P ＜ 0.00001]; clinical neurological deficit score (CSS) [MD =-3.85, 95％CI (-5.21, -2.50), Z =5.56, P ＜ 0.00001]; limb motor function score (FMA) [MD =6.10, 95％CI (1.19, 11.01), Z =2.43, P =0.01]; Barthel Index of Daily Living Activity Scale [MD =9.09, 95％CI (6.95, 11.23), Z =8.33, P ＜ 0.00001]; In terms of improving blood rheology index, serum peroxide lipid (LPO), serum superoxide dismutase (SOD) and other biochemical indicators, due to the small number of studies, it may have a certain effect. Most studies did not report adverse reactions. Conclusion: Based on the existing clinical evidence, combination of Buyang Huanwu decoction and western medicine has higher clinical efficacy than western medicine alone for the ischemic stroke recovery. Due to the limited methodological quality of the included studies, more high- quality RCTs with large scale are needed to increase the strength of the above evidence.

Objective:To investigate the effect of self-made phase-change nanodroplets IR780/FA-Nds-DTX as molecular targeted ultrasound contrast agents for accurate diagnosis and combined targeted therapy of pancreatic cancer.Methods:Pancreatic cancer cell lines were cultured in vitro and 50 tumor bearing nude mouse models were established. The experimental group (IR780/ FA-NdS-DTX) and four control groups[ normal saline, Nds(FITC), FA-Nds (FITC) and IR-780] were divided to verify dual-mode targeted imaging. The imaging using the IVIS Imaging System verified the high-efficiency targeted detection ability and near-infrared fluorescence imaging of IR780/FA-Nds-DTX for tumors in vivo, phase transformation induced by low-intensity focused ultrasound and further contrast-enhanced ultrasound imaging verified the high-efficiency aggregation of IR780/FA-Nds-DTX in local tumors and accurate evaluation of tumor contour. The therapeutic effect was observed in the experimental group (IR780/FA-Nds-DTX) and four control groups (FA-Nds-IR780, FA-Nds-DTX, FA-Nds and normal saline). After low-intensity focused ultrasound irradiation for 30s induced microbubble blasting after phase transformation in each group, 808nm photothermal therapy apparatus was used to irradiate tumor area in each group. Two-dimensional ultrasound was used to monitor the changes in tumor volume in each group before and at 3 d, 9 d, 15 d after treatment, and the changes in tumor volume rate and inhibition in each group were statistically analyzed and compared.Results:The amount of IR780/ FA-Nds-DTX locally targeted aggregation was the largest, and the average fluorescence intensity of tumor in the experimental group was significantly higher than that of the control groups: IR780/ FA-Nds-DTX group compared with Nds(FITC) group[(5.12±0.69)×10 7 vs (1.06±0.23)×10 7, P<0.05], IR780/FA-Nds-DTX group compared with FA-Nds (FITC) group [(5.12±0.69)×10 7 vs (2.98±0.34)×10 7, P<0.05], IR780/FA-Nds-DTX group compared with IR-780 group [(5.12±0.69)×10 7 vs (1.54±0.42)×10 7, P<0.05], and there was no fluorescence in tumor area in saline group. Further contrast-enhanced ultrasound imaging after nanodroplet phase transformation could more accurately locate the tumor boundary. After 15 days of photothermal ablation combined with chemotherapy, the growth rate of tumor volume in the IR780/ FA-Nds-DTX treatment group was significantly lower than that in the control groups: IR780/FA-Nds-DTX group compared with FA-Nds-IR780 group[(0.105±0.075) vs (0.405±0.175), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds-DTX group [(0.105±0.075) vs (1.385±0.035), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds group [(0.105±0.075) vs (2.255±0.105), P<0.05], IR780/ FA-Nds-DTX group compared with normal saline group [(0.105±0.075) vs (2.185±0.155), P<0.05]. And the tumor inhibition rate increased significantly: IR780/ FA-Nds-DTX group compared with FA-Nds-IR780 group [(0.93±0.06) vs (0.48±0.17), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds-DTX group [(0.93±0.06) vs (-0.51±0.105), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds group [(0.93±0.06) vs (-1.63±0.115), P<0.05], IR780/ FA-Nds-DTX group compared with normal saline[(0.93±0.06) vs (-1.35±0.245), P<0.05]. Conclusions:The self-made phase-change ultrasound contrast agents IR780/FA-Nds-DTX have good potential clinical value in targeted detection and combined therapy of pancreatic cancer with small lesions or even metastases.

Lung squamous cell carcinoma with intratracheal diffuse leukoplakia as the main manifestation is very rare in clinic. The clinical data of a patient with pulmonary squamous cell carcinoma with intratracheal diffuse leukoplakia admitted to the Affiliated Hospital of Jining Medical University in December 25, 2021 were retrospectively analyzed in order to improve the understanding of this special manifestation. The patient was a 73-year-old male with clinical manifestations of cough, sputum, and blood-stained sputum. Chest CT indicated patchy high-density shadow on the upper right lung, whole-course thickening of trachea and bronchial walls, and bronchoscopy showed diffuse trachea-bronchial mucosa congestion and edema, with a large number of leukoplakia on the surface. The clinical effect was stable after 2 cycles of chemotherapy. Lung squamous cell carcinoma accompanied by diffuse leukoplakia in the trachea is a rare presentation. Chest CT can show thickening of the tracheal and bronchial wall, while the lesion and tumor signs of the primary lesion are not obvious. Electronic bronchoscopy as soon as possible can avoid missed diagnosis.

【Objective】 To describe the current situation of sleep duration and living environment of school-aged children so as to analyze the effects of the living environment on sleep duration comprehensively and provide advice for improving children’s sleep duration. 【Methods】 By cluster sampling, 82 families were selected from 1 rural and 2 urban areas in Xi’an. Data were collected by questionnaire survey and environmental sampling. Proportion was used for statistical description, and factor analysis and pathway analysis were used for statistical analysis. 【Results】 50.0% of the school-aged children in Xi’an slept less than 8 hours. Pollution was mainly caused by lower humidity, CO2, temperature, PM10 and aerobic bacterial count, their standard-exceeding rates being 26.8%, 21.3%, 5.5%, 4.3% and 1.8%, respectively. The results of path analysis showed that the influencing factors were as follows in a descending order: strong night light (1.031), presence of the computer (0.549), pressure (0.444), pets (0.408), distance from the driveway (-0.390), humidifier (-0.219), potted plants (0.138), indoor environment factors (0.098), and the floor level (0.039). 【Conclusion】 The sleep duration of school-aged children in Xi’an is relatively inadequate. More attention should be paid to indoor humidity, CO2, temperature, PM10 and aerobic bacterial count. The children’s sleep duration is positively correlated with a good indoor environment, humidifier, being away from the driveway, and low floor level, but is negatively correlated with pressure, strong night light, keeping pets, using computer and potted plants. We need to pay more attention to these factors to improve the sleep quality of school-aged children.