OBJECTIVE: To prepare ethacridine lactate solution and to evaluate its quality.METHODS: The solution was prepared with ethacridine lactate as principal components and sterilized by steam sterilization.HPLC method was used for the determination of ethacridine.Calesil ODS column was used with mobile phase consisted of methanol-acetonitrile-0.05% sodium laurysulfonate (pH=3.0,20 ∶ 20 ∶ 60) at detection wavelength of 270 nm.The column temperature was set at 30 ℃ and injection volume was 10 ?L.The effect of sterilization on the content of preparation was determined.RESULTS: The preparation assumed as yellow transparent solution.The linear range of ethacridine was 5～50 ?g?mL-1(r=0.999 9) with an average recovery of 101.47% (RSD=1.32%,n=9).The content of ethacridine in the solution was not changed after sterilization.CONCLUSION: The quality of prepared ethacridine lactate solution is up to the standard.

Objective To investigate the efficacy and adverse effect of herceptin combined with docetaxel in patients with localized advanced breast cancer. Methods 16 patients with localized advanced breast cancer were treated with herceptin (8 mg/kg in the first cycle and 6 mg/kg from 2 to 4 cycles,d1) and docetaxel (75 mg/m2 ,d2) for 4 cycles. Three weeks were taken as a cycle. Following chemotherapy, the patients underwent improved radical operation of breast cancer or radical operation of preserving breast. Results The overall response rate (oRR) was 87.5%. The complete clinical remission rate (cCR) was 56. 3%. The complete pathologic remission rate (pCR) was 25.0%. The mainly adverse effects were bone marrow depression and gastrointestinal toxicity. Conclusion The regimen of herceptin combined with docetaxel is effective and can be well-tolerated by patients with localized advanced breast cancer. It shows promising prospect in clinical application.

OBJECTIVE: This study aims to examine the parallel multiple mediators of depressive symptoms and sleep quality in the relations between stress and physical health-related quality of life (PHQOL)/mental health-related quality of life (MHQOL) among the women in late pregnancy. METHODS: Of 1120 pregnant women participated in the cross-sectional study which consisted of Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index and MOS 12-item Short Form Health Survey. Parallel multiple mediator models were used to analyze the relations between stress, depressive symptoms, sleep quality and PHQOL/MHQOL. RESULTS: The effect of perceived stress on PHQOL was partially through the indirect path of sleep quality (β=-0.061). But in the model for MHQOL, depressive symptoms and sleep quality played parallel mediators, and the indirect path effect of depressive symptoms (β=-0.179) was higher than sleep quality (β=-0.029). CONCLUSION: The findings contributed to the understanding about the influential mechanism of stress on PHQOL/MHQOL. And it reminded the importance of sleep quality and depressive symptoms for improving QOL in late pregnancy.
Cross-Sectional Studies ; Depression ; Depression, Postpartum ; Female ; Health Surveys ; Humans ; Negotiating ; Pregnancy ; Pregnant Women ; Quality of Life

Objective: To investigate and compare the advantages of surgical treatment of ingrown toenail with the traditional Winograd method. Methods: From Aug. 2013 to Jun. 2015, 77 cases (89 toes) with 15-58 years were involved in the study. 37 cases (42 toes) were treated with Winograd method and other 40 cases (47 toes) were treated with a method using lateral incision without cutting the nail fold. The time of returning to normal activities, infection rate, recurrence rate, pain VAS score and shape satisfaction VAS score were evaluated to display the aesthetic and functional result of the both methods. Results: All patients were followed up with an average of 8.6 months. The patients treated with the novel method returned to normal activities after (5.3±0.5) d post-surgery, which was much shorter than that (7.3±0.6) d in patients with the Winograd method (P<0.05). And the infection rate in the lateral incision group was also lower than that in the Winograd method group (P<0.05). At 3 days post-surgery, the pain VAS score in Winograd method group was higher (P<0.05), but the difference of pain VAS score disappeared after 1 and 6 months post-surgery (P>0.05). The shape satisfaction VAS score were 9.2±0.6 in the lateral incision group and 7.1±0.7 in the Winograd group, showing significant difference (P<0.05). Conclusions The lateral incision method without incising the nail fold reserves the nail groove and brings faster recovery to normal activities with less pain, lower infection rate and more satisfactory toenail shape.

Background In recent years, the incidence of metabolic syndrome (MS) is increasing significantly in China. Some studies have found that temperature is related to single metabolic index, but there is a lack of research on associated mechanism and identifying path of the influence of temperature on MS. Objective Based on the data of Guangdong Province, to investigate the effect of temperature on MS and its pathway. Methods A total of 8524 residents were enrolled by multi-stage random sampling from October 2015 to January 2016 in Guangdong. Basic characteristics, behavioral characteristics, health status, and physical activity level were obtained through questionnaires and physical examinations, and meteorological data were obtained from meteorological monitoring sites. We matched individual data both with the temperature data of the physical examination day and of a lag of 14 d. A generalized additive model was used to explore the exposure-effect relationship between temperature and MS and its indexes, calculate effect values, and explore the effects of single-day lag temperature. Based on the literature and the results of generalized additive model analysis, a path analysis was conducted to explore the pathways of temperature influencing MS. Results The association between daily average temperature on the current day or lag 14 day and MS risk was not statistically significant. When daily average temperature increased by 1 ℃, the change values of fasting blood-glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high density lipoprotein cholesterol (HDL-C) were −0.033 (95%CI: −0.040-−0.026) mmol·L⁻¹, −0.662 (95%CI: −0.741-−0.583) mmHg, −0.277 (95%CI: −0.323-−0.230) mmHg, and −0.005 (95%CI: −0.007-−0.004) mmol·L⁻¹ respectively. The effects of average daily temperature on FBG, blood pressure, HDL-C, and waist circumference lasted until lag 14 day. The effects of daily average temperature on SBP and DBP were the largest on the current day. Daily average temperature of current day had direct and indirect effects on FBG and SBP. Temperature had an indirect effect on TG, and the intermediate variables were waist circumference and FBG, with an indirect effect value of −0.011 (95%CI: −0.020-−0.002). The indirect effects of daily average temperature on SBP, FBG, and TG were weak. Conclusion There is no significant correlation between temperature and risk of MS, and daily average temperature of current day could significantly affected blood pressure and FBG with a lag effect. Daily average temperature of current day has indirect effects on FBG and TG.

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 investigate the morphological characters of the dorsal perforators originated from the deep palmar arch, so as to provide anatomic basis for V-Y advanced perforator flap. Methods: The following contents were investigated in 30 adult hand specimens perfused with red latex under surgical magnifier: ①The origin, courses, branches and distribution of the dorsal perforators originatedd from the deep palmar arch. ②The characters of anastomosis among the dorsal perforators, the dorsal carpal and metacarpal arteries. Mimic operation was performed on another fresh specimens perfused with red latex. Results: There were three perforators originated from the deep palmar arch, which passed through the 2nd-4th dorsal interossei and then divided into an ascending branch and a descending branch at the dorsum of hand. Then the ascending branch anastomosed with the dorsal carpal artery, and the descending branch stretched to the 2nd-4th dorsal metacarpal arteries. The originating outer diameters of the 1st-3rd perforators were (1.1±0.2) mm, (0.9±0.3) mm and (0.7±0.1) mm respectively, and the length of the stems were (1.1±0.3) cm, (1.0±0.2)cm and (0.9±0.1) cm respectively. Conclusions The V-Y advanced perforator flap with the dorsal perforator of the deep palmar arch as its vascular pedicle could be used to repair the dorsal carpal or dorsal metacarpal soft tissue defects.

Objective To explore the feasibility of the perforator-based intermediate dorsal pedal flap with vessels of cutaneous nerve nutrition for repair of soft tissue defects of the forefoot.Methods A retrospective case series study was performed for seven cases of soft tissue defects of the forefoot hospitalized between February 2013 and January 2017.There were five males and two females,with a mean age of 38 years (range,18-73 years).Injury regions were lateral plantar skin defect in the forefoot in three cases,dorsal skin defect in the third webbed toe in two cases and proximal dorsal skin defect in the fourth toe in two cases.The defect area was about 2.5 cm × 1.5 cm-4.5 cm × 2.0 cm.The perforator-based intermediate dorsal pedal flap with vessels of cutaneous nerve nutrition was designed on the lateral dorsum of the foot and then was incised and transferred to repair the forefoot wound based on its surgical anatomy.The time of surgery and the amount of intraoperative blood loss were recorded.An observation was done on feeling,appearance,texture,blood supply and survival of the flap as well as swelling,hypertrophic scar,itching,paralysis of the skin grafting area.The recovery of the activity function was assessed by American Orthopedic Foot & Ankle Society (AOFAS) score.Results The surgery time was 1.0-1.5 h (mean,1 h),and intraoperative bleeding was about 50 ml (range,30-100 ml).Seven cases of perforator-based dorsal medial skin flap with vessels of cutaneous nerve nutrition all survived,with early wound healing.After 2 to 15 months follow-up,two-point discrimination of flaps was 9-15 mm(average,12.5 mm).Skin flaps were with excellent texture and without swelling,the color of which was close to normal color with good appearance.The postoperative foot did not have bone resorption,wound infection,tendon adhesion,line-type or flaky scar left locally,lower limb walking dysfunction or other complications.Patients were satisfied with the functions of donor and recipient sites and the appearance of the flap.Conclusions Perforation-based dorsal flap with vessels of cutaneous nerve nutrition has high survival rate,satisfaction of appearance and fast recovery of recipient site,with no obvious foot pain,limitation of joint movement or other complications,and therefore is a reliable method to repair soft tissue defects in forefoot.

Objective:To investigate the influences of morphological characteristics of skull base ovale foramen in the puncture difficulty of percutaneous balloon compression (PBC), surgical efficacy and postoperative complications in patients with idiopathic trigeminal neuralgia (ITN).Methods:One hundred and twenty-seven patients with ITN, admitted to our hospital from January 2020 to January 2021, were collected. Dyna-CT three-dimensional imaging of the oval foramen at the skull base and PBC treatment were performed on the included patients, and the morphological data of the oval foramen were measured. Numeric Rating Scale (NRS) was used to assess pain degrees before and after surgery. The differences of cross-sectional area and exposure Angle, puncture difficulty and time, NRS scores before and after surgery and incidence of complications were compared in patients with ovale foramen at different forms. The correlations of puncture time with puncture difficulty and cross-sectional area of ovale foramen in skull base were analyzed.Results:The foramen ovale in skull base of 127 patients included standard oval shape ( n=82), almond shape ( n=9), narrow and long shape ( n=13), fissure shape ( n=8) and irregular shape ( n=15). Different morphological characteristics of the skull base ovale foramen could lead to significant differences in the difficulty of puncture, exposure angle, cross-sectional area and puncture time ( P<0.05). Puncture time was positively correlated with puncture difficulty and cross-sectional area ( r=0.359, P<0.001; r=0.280, P=0.007). The patients with skull base ovale foramen of different forms showed no significant differences in the differences of NRS scores before and after PBC and occurrence of postoperative complications ( P>0.05). Conclusion:Dyna-CT three-dimensional imaging can visually display the morphological characteristics of the oval foramen at the skull base; this technique can be used to guide the puncture of the oval foramen and effectively evaluate the difficulty of puncture in PBC, but it does not affect the postoperative pain improvement and complication incidences.

Objective To explore the anatomical characteristics of mediate dorsal pedal cutaneous nerve and its nutritional vessels to provide anatomical basis of the perforator pedicle flap based on the medial dorsal pedal neurocutaneous vessels for repairing the forefoot soft-tissue defects.Methods From December,2016 to April,2017,the following contents were investigated in 30 adult feet specimens perfused with red latex:①The course,branches and distribution of the medial dorsal pedal cutaneous nerve.②The origin,course,branches and distribution of the nutrient vessels of the medial dorsal pedal neurocutaneous vessels.Mimic operation was performed on 1 fresh specimen.Results ①The mediate dorsal pedal cutaneous nerve mainly arose from the medial branch of the superficial peroneal nerve and processed forward for a distance of (2.5±0.4) cm under the surface of the inferior extensor retinaculum,and then divided into the mediate dorsal branch,the 1st and 2nd dorsal metatarsal branch over part of the dorsal pedal and digital skin.②The medial dorsal pedal neurocutaneous vessels were multiple segmental and polyphyletic,mainly include dorsalis pedis artery proximal perforator,the first metatarsal proximal perforator,the tibial proper plantar digital artery of the great toe and the perforater of the second toe web artery,of which the first metatarsal proximal perforator was most associated with operating methods.The first metatarsal proximal perforator perforate through the deep fascia to the subcutaneous area within the range of 1.0-2.0 cm near the proximal first plantar gap,the piercing point of which on deep fascia was constant,and the anatomical plane of the first metatarsal proximal perforator was higher than that of both the perforator of the toe web artery and the tibial proper plantar digital artery of the great toe.The first metatarsal proximal perforator divide into a large number of branches,which closely anastomose with adjacent perforators and other medial dorsal pedal neurocutaneous vessels.③Simulated surgery showed that the first metatarsal proximal perforation pedicle flap to meet the forefoot soft tissue defect repair.Conclusion The first metatarsal proximal perforator is constant in piercing point and reliable in blood supply,and it have a higher anatomical plane than that of both the perforator of the toe web artery and the tibial proper plantar digital artery of the great toe.The first metatarsal proximal perforator-based medial dorsal pedal neurocutaneous vascular flap can be transferred to repair the soft-tissue defects of forefoot.