The extensive application of radiotherapy and the long survival of patients with malignant tumors have led to an in-creased incidence rate of radiation-induced osteosarcoma (RIOS), one of the most critical radiation-induced complications. Compared with primary osteosarcoma, RIOS has higher grade and poorer prognosis, which reduces the survival of patients with cancers. However, RIOS has not been fully understood in the clinical setting. This paper summarizes the latest progress at home and abroad, focusing on the incidence rate, risk factor, latency, and diagnostic criteria of RIOS. The molecular mechanism of RIOS is associated with the muta-tion of p53, the activation of the Wnt/β-catenin signaling pathway, and the superposition of multiple alleles. Furthermore, we discuss the differences in clinical characteristics, imaging findings, treatment, and prognosis between primary osteosarcoma and RIOS.

Objective To study the percentage of HBV specific CD3 + T cells in the peripheral blood of chronic hepatitis B patients. Methods HLA A 2 patients were screened by MHC:Ig dimer reagent. HLA A 2 restricted HBV core, polymerase, and surface peptides were added to T cells of chronic hepatitis B patients, followed by double staining with anti CD3 antibodies and antibodies reactive with the heavy chain of Ig. FACS was used for monitoring HBV specific T cell percentage. Results 23/54 (42.6%) patients belonged to HLA A 2. Fifteen of them were reacted with HBV peptides. CD3 + T cells of five patients showed higher percentage of binding with the HBV peptides than that in the controls. Four patients showed CD3 + T cells binding with S peptide, one with P peptide and one binding with both S and P peptide. Conclusions The percentage of T cells which could bind with HBV peptide was low in chronic hepatitis B and the binding efficiency was low as well. The MHC:Ig dimer reagent is convenient for counting the number of HBV specific T cells, but the nonspecific staining background seems to be relatively high. However, this technology is useful to monitor changes of immune responses in chronic hepatitis B patients during immuno therapy.

Objective To study the influence of different placing time of child peripheral blood on blood routine parameters in order to increase the working efficiency of clinical blood routine test.Methods Each 300 μL of peripheral blood was collected from the right hand ring finger in 50 healthy children in our hospital from January 2015 to January 2016.The blood routine was performed by using the whole blood cells analyzer at instantly after blood collection,at 0,5,10,15,30 min after blood collection under the room temperature (20 to 25 ℃).Results With the measured results at 15 min as the control,the detection results at the other times points had no statistical difference (P>0.05).Compared with the detection results at 5 min,the white blood cell count(WBC) and platelet volume distribution width (PDW),lymphocyte absolute value (LYM),neutrophil percentage absolute value (NEU),platelet count (PLT),red blood cell volume distribution width (RDW),hemotocrit (HCT) and plateletcrit(PCT) were statistically different (P<0.05).Conclusion Reasonably arranging time,eliminating pre-analysis error and reducing the influence of peripheral blood placing time on blood routine parameters have an important significance to accurately judge the clinical dat.It is recommended that the blood routine detection time should be controlled within 10-30 min in order to increase the working efficiency of clinical detections.

Objective　To investigate the genomic methylation pattern of a malignant glioma cell line in the process of differentiation induced by nordihydroguaiaretic acid (NDGA). Methods　Methylation-sensitive arbitrarily primed PCR was used to study the genomic methylation changes. Results　Fragments of genomic DNA of PCR products in control groups digested with MspⅠ were smaller than those with HpaⅡ. No large fragment could be identified and at least three fragments of different sizes were demonstrated in the control group. In NDGA treatment group, comparing MspⅠ digestion with HpaⅡ digestion, the amount of PCR products was smaller with more DNA bands. The amount of PCR products in NDGA treatment group was increased with more DNA bands compared with that in the control groups. Conclusion　The genomic methylation level in SHG-44 cells was increased by NDGA in the differentiation process of SHG-44 cells. It suggests that genomic methylation pattern may be one of the targets for glioma cell differentiation induced by NDGA.

Objective To study the association among gastric mucosal lesions caused by primary pathological duodenogastric reflux(DGR),H.pylori infection,and bile reflux.Methods Twenty-four hour intragastric bilirubin monitoring were performed on 58 patients with primary pathological DGR.The patients were divided into high reflux group(n=29)and lOW reflux group(n=29)based on the severity of bile reflux(＜23.60%).The association among gastric mucosal lesions,H.pylori infection,and bile reflux were analyzed.Results The positive rate of H.pylori infection was 20.7% (6/29)in high reflux group and 48.3%(14/29)in low reflux group(P＜0.05).The frequency of intestinal metaplasia in gastric antrum and angularis in high reflux group was higher than that in low reflux group(P＜0.05).The pathological scores of gastric antrum and angularis in H.pylori positive group and high reflux group were higher than those in H.pylori negative group and low reflux group (P＜0.05).The time percentage of bilirubin absorbance≥0.25 in H.pylori positive group was lower than that in negative group(P＜0.05),while the difference in short reflux frequency,long reflux frequency,longest reflux time,maximum,mean and median value of absorbance between H.pylori positive and negative groups showed no significant difference(P＞0.05).The time percentage of bilirubin absorbance≥0.25 was positively correlated with pathological scores of gastric antrum and angularis in both H.pylori positive and negative groups(P＜0.05),but was not correlated with that of gastric body(P＞0.05).Conclusions In patients with primary pathological DGR,excessive bile reflux is related to chronic lesion of gastric mucosa.regardless of H.pylori infection.Bile reflux may inhibit H.pylori to locate in gastric mucosa.H.pylori infection and bile reflux may co-contribute to gastric mucosal lesions.

Objective:To observe the efficacy of Tegafur gimeracil oteracil potassium(Gio) capsules combined with oxaliplatin in the treatment of advanced gastric cancer,and explore its effect on matrix metalloproteinase-9 (MMP-9) expression in cancer tissues. Methods: Totally 120 patients with advanced gastric cancer were randomly divided into the observation group and the control group, and both groups were treated with neoadjuvant chemotherapy for 3 cycles as follows:the observation group was given Gio capsules and oxaliplatin,and the control group was given 5-fluorouracil combined with oxaliplatin. The short term efficacy,adverse reactions and ex-pression of MMP-9 in cancer tissue before and after the chemotherapy were observed in the two groups. Results:After the treatment, the objective response rate in the two groups had no significant difference(P>0.05);the clinical benefit rate of the observation group was significantly higher than that of the control group(P<0.05);the incidence of severe bone marrow suppression and liver and kid-ney dysfunction in the observation group was significantly lower than that in the control group(P<0.05);after the treatment,the pos-itive expression of MMP-9 in the observation group was significantly lower than that in the control group(P<0.05). Conclusion:Gio capsules combined with oxaliplatin can improve the clinical benefit rate of the patients with advanced gastric cancer,and effectively re-duce the expression of MMP-9 in cancer tissue.

Objective? To investigate the occurrence and influencing factors of falls in elderly patients with knee osteoarthritis (KOA), and provide scientific reference for the prevention of falls in elderly patients with KOA. Methods? Using convenience sampling method, 104 elderly patients diagnosed as KOA in orthopaedic wards of four ClassⅢ Grade A hospitals in Hangzhou from November 2017 to August 2018 were selected as subjects. General Information Questionnaire, Morse Fall Scale(MFS)and the Barthel Index(BI)for Activities of Daily Living (ADL) were applied in the investigation. Single factor analysis and multiple factor Logistic regression were used to analyze the influencing factors of falls in elderly KOA patients. Results? A total of 104 questionnaires were sent out in this study, and 95 valid questionnaires were recovered, yielding an effective recovery rate of 91.35%. The incidence of falls in elderly KOA patients was 45.26% (43/95), of which 62.79% (27/43) had fallen twice or more. There were significant differences in knee injury history, staircase climbing and falls among elderly KOA patients (P＜ 0.05). There were significant differences in the risk of falls between elderly KOA patients in "whether taking drugs", "whether using walking aids", "status of self-care ability", and "age" (P＜ 0.05). Logistic regression analysis showed that history of knee injury, frequent staircase climbing and use of walking aids were the influencing factors of falls in elderly KOA patients (OR=4.028, 25.569, 3.191; P＜ 0.05). Conclusions? In view of the influencing factors of falls in elderly KOA patients, individualized nursing measures should be taken to strengthen falls risk assessment, carry out fall prevention related education and improve patients' social support, which will help to reduce the incidence of falls and further improve patients' quality of life.

Objective:To explore effects of psychological resilience and social support on quality of life in patients undergoing ileal conduit surgery.Methods:Using the convenient sampling method, a total of 232 patients who underwent total cystectomy and ileal conduit surgery in Department of Urology in a Class ⅢGrade A general hospital from January 2014 to December 2018 were investigated by using the general data questionnaire, City of Hope Quality of Life-Ostomy Questionnaire (COH-QOL-OQ) , Perceived Social Support Scale (PSSS) and 10-item Connor Davidson Resilience Scale (CD-RISC-10) from March to August 2020.Results:The age of patients was (65.79±8.67) years old, the postoperative time was (42.14±15.76) months, the total score of quality of life was (263.28±28.71) , the score of social support was (71.81±8.02) and the score of psychological resilience was (31.27±5.27) . Multiple linear regression analysis showed that psychological resilience (β=0.18, P<0.01) , self-care (β=0.30, P<0.01) , age (β=0.18, P<0.01) , recurrent carcinoma (β=0.13, P<0.05) and self-paying (β=-0.21, P<0.05) were influence factors of quality of life of patients, which could explain the variability of 21.2%. Conclusions:A variety of factors affect quality of life of patients after ileal conduit surgery for a long time. Therefore, attention should be paid to continuing treatment and nursing, improving self-care ability and psychological quality, promoting quality of life and improving disease outcomes.

Objective: To investigate the differences in dentin structure, mineral content and microhardness of single premolar roots with or without an isthmus. Methods : Thirty single-root premolars with a canal isthmus (experimental group) and thirty single-root premolars without a canal isthmus (control group) were collected and analyzed by scanning electron microscopy, X-ray energy spectrometry and a Vickers microhardness tester. Structure, mineral content and microhardness were compared. Results In the experimental group, the dentinal tubules were not obvious, and the structure was disordered. In the control group, the dentin tubules of the root canal wall were arranged regularly, and the lumen opening was clear. The Ca and P contents and Ca/P ratio of the experimental group were lower than those of the control group (P < 0.05). The microhardness of the experimental group was less than that of the control group (P < 0.05). Results: In the experimental group, the dentinal tubules were not obvious, and the structure was disordered. In the control group, the dentin tubules of the root canal wall were arranged regularly, and the lumen opening was clear. The Ca and P contents and Ca/P ratio of the experimental group were lower than those of the control group (P < 0.05). The microhardness of the experimental group was less than that of the control group (P < 0.05). Conclusion The dentin structure of the root canal isthmus was changed, and the Ca, P contents and microhardness were low. The root canal isthmus was a weak link in the root, which could weaken the resistance of the hard tissue of the root tooth, which may be one of the important factors that could cause vertical root fracture.

Objective:To explore the effect of time-sensitive incentive nursing on psychological resilience, quality of life, nursing satisfaction and disease cognition of postoperative patients with chronic sinusitis (CS) .Methods:From January 2019 to July 2020, the convenience sampling method was used to select 60 postoperative patients with CS who were admitted to Fuyang Hospital of Anhui Medical University as the research objects. Patients were randomly divided into the observation group and the control group, with 30 cases in each group. The control group carried out conventional nursing, and the observation group was given conventional nursing combined with time-sensitive incentive nursing. The Connor-Davidson Resilience Scale (CD-RISC) , the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) dimensions of mental health, general health, physical functioning and role emotional were used to compare the psychological resilience and quality of life of the two groups of patients before and after nursing. Disease cognition and nursing satisfaction of the two groups of patients after nursing were compared.Results:The scores of the CD-RISC dimensions, disease cognition, four dimensions of the SF-36, and nursing satisfaction of patients in the observation group after nursing were higher than those of the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The application of time-sensitive incentive nursing in postoperative patients with CS can improve their psychological resilience, disease cognition, quality of life and nursing satisfaction.