Objective To evaluate the role of mangled extremity severity score(MESS)in res-ervation and amputation of crush lower limbs in earthquake. Methods There were 122 patients with crush lower limb injuries,with MESS≥8 points in 34 patients who were primarily amputated,M ESS 5-7points in 19 who were principally preserved and MESS＜5 points in 69 who were preserved by means of debridement,external fixators,plast splints and vaeuum sealing drainage technique.Results All pa-tients were survived.with amputation rate of 29.5%. Conclusion MESS is an important reference for evaluation of reservation and amputation of crush limb injuries caused by earthquake.

Objective:To understand the current state of financial toxicity and suicide risk in head and neck cancer patients, to investigate the correlation between the level of financial toxicity and suicide risk in head and neck cancer patients, and to provide a basis for reducing the level of financial toxicity and the risk of suicide in head and neck cancer patients.Methods:A cross-sectional survey was conducted, from March 1 to July 31, 2022, 150 head and neck cancer patients were selected from Oncology Department of East Hospital Affiliated to Tongji Universityby by convenient sampling method. The survey was carried out by means of the general questionnaire, Comprehensive Score for Financial Toxicity based on the Patient-Reported Outcome Measures (COST-PROM), Cancer Suicide Risk Scale (CSRS), and then analysis the datum.Results:The score of COST-PROM of 150 head and neck cancer patients was (18.00 ± 6.12) points, and the score of CSRS of head and neck cancer patients was (36.31 ± 8.51) points. The total score of economic toxicity was significantly negatively correlated with the total score of suicide risk and its dimensions ( r values were -0.446 to 0.235, all P<0.05). The total score of suicide risk was negatively correlated with the total score of economic toxicity and the scores of each dimension ( r values were -0.446 to -0.251, all P<0.05). Conclusions:Patients with head and neck cancer were at higher risk of suicide, and financial toxicity was a significant contributing factor to suicide risk, with higher levels of financial toxicity associated with a higher risk of suicide. Reducing the level of financial toxicity in patients with head and neck cancer has important implications for reducing their risk of suicide.

Objective:To optimize the paper-roasted technology of Aucklandiae Radix. Methods:With methanol-water (65: 35) as the mobile phase, the contents of costunolide and dehydrocostuslactone were determined by HPLC. Senna was used to make diarrhea model in mice, and the sample decoction was administered for the mice by i. g at the dose of 10 g·kg-1 and the diarrhea index was de-termined. The paper-roasted technology of Aucklandiae Radix was optimized by L9 (34 ) orthogonal design taking the contents of cost-unolide and dehydrocostuslactone, and the diarrhea index in mice as the indices with the paper-roasted time, the paper-roasted temper-ature and the layer number as the influencing factors. Results:The variance analysis results show that the layer number and the paper-roasted temperature has the significant impact on the contents of costunolide and dehydrocostuslactone and the diarrhea index in mice. The best paper-roasted technology of Aucklandiae Radix was as follows:a layer of paper was covered by 4mm Aucklandiae Radix and repeated the same operation 5 times, and put them in drying baker at 120℃ for about 2 hours. After the essential oil of Aucklandi-ae Radix permeated on the paper with burnt flavor and dark brown in color, Aucklandiae Radix could be taken out. Conclusion:The optimum paper-roasted technology of Aucklandiae Radix is reasonable and feasible, which can provide reference for the establishment of the quality standard for paper-roasted Aucklandiae Radix pieces and the expanding of the clinical application.

Space-occupying lesions in the pancreas have complex etiologies, various types, and different treatment methods, and the diagnosis and differential diagnosis of such lesions have always been a difficult issue in clinical practice. Endoscopic ultrasound (EUS) is a relatively sensitive and effective method for space-occupying lesions in the pancreas. This article reviews the advances in the value of EUS in the diagnosis of space-occupying lesions in the pancreas, introduces the efficiency of EUS in common space-occupying lesions in the pancreas, and elaborates on the latest advances in EUS-guided fine-needle aspiration and other related techniques in the diagnosis of space-occupying lesions in the pancreas.

BACKGROUND:Allogeneic hematopoietic stem cell transplantation is an effective and even the only way to cure various hematological diseases,but the short-term mortality rate is relatively high after transplantation. OBJECTIVE:To investigate the risk factors affecting the overall survival of patients with hematological diseases in the short term(within 100 days)after allogeneic hematopoietic stem cell transplantation,so as to reduce mortality and effectively prevent related risks in the short term(within 100 days)after allogeneic hematopoietic stem cell transplantation. METHODS:Clinical data of 585 patients with hematological diseases who underwent allogeneic hematopoietic stem cell transplantation at the Hematopoietic Stem Cell Transplantation Center of First Affiliated Hospital of Zhengzhou University from January 1,2018 to June 30,2021 were retrospectively analyzed.The risk factors that affected overall survival within 100 days after allogeneic hematopoietic stem cell transplantation were explored. RESULTS AND CONCLUSION:A total of 585 patients with hematologic diseases underwent allogeneic hematopoietic stem cell transplantation.92 patients died within 100 days after transplantation,with a mortality rate of 15.7%(92/585).The median age of death cases was 26.5 years old(1-56 years),and the median survival time of death cases was 48 days(0-97 days).Univariate analysis exhibited that age≥14 years old,acute graft-versus-host disease,grade IV acute graft-versus-host disease,bacterial bloodstream infection,as well as carbapenem-resistant organism bloodstream infection,were risk factors for overall survival within 100 days after allogeneic hematopoietic stem cell transplantation(P<0.05).Multivariate regression analysis showed that age≥14 years old,grades Ⅲ-Ⅳ acute graft-versus-host disease,bacterial bloodstream infection,and carbapenem-resistant organism bloodstream infections were independent risk factors for overall survival(within 100 days)in patients after allogeneic hematopoietic stem cell transplantation.Hazard ratios were 1.77(95%CI 1.047-2.991),7.926(95%CI 3.763-16.695),2.039(95%CI 1.117-3.722),and 3.389(95%CI 1.563-7.347),respectively.In conclusion,all-cause mortality rate after allogeneic hematopoietic stem cell transplantation is relatively high in the short term.A timely diagnosis and effective treatment of bacterial bloodstream infection and acute graft-versus-host disease are essential to improving allogeneic hematopoietic stem cell transplantation outcomes.

Objective : To explore the role of T cell 17/regulatory T cell (Th17/Treg) related cytokine imbalance in the pathogenesis of preeclampsia . Methods : Serum samples from 50 preeclampsia pregnant women and 30 normal pregnant women were collected , and the concentration of interleukin⁃23(IL⁃23)and interleukin⁃2 recepter(IL⁃2R) in serum was tested using ELISA . Additionally , the concentration of interleukin⁃6( IL⁃6) and interleukin⁃10( IL⁃10)in serum was measured using cell microsphere array(CBA) technology. Then placental and decidual tissues of 10 pregnant women with preeclampsia and 6 normal pregnant women were selected for further verification of the expression of related cytokines by using QPCR and immunohistochemistry . Results : The concentrations of IL⁃10 , IL⁃2R , IL⁃23 and IL⁃6 in the serum of preeclampsia pregnant women were higher than those of normal pregnant women (P < 0. 05) . The QPCR results showed that , compared to normal pregnant women , there was no statisticly significant difference in the expression of IL⁃23 mRNA in the placenta and decidua tissues of preeclampsia patients (P > 0. 05) , while the expression level of IL⁃10 mRNA in the placenta and decidua tissues of preeclampsiapatients was lower than that of normal pregnant women , with a statistically significant difference (P < 0. 05) . The expression level of IL⁃2R mRNA in the placenta and decidua tissues of preeclampsia patients was higher than that of normal pregnant women , with a statistically significant difference ( P < 0. 05 ) . The immunohistochemical results showed that the expression of IL⁃10 in the placenta and decidua of preeclampsia pregnant women was lower than that of normal pregnant women , with a statistically significant difference (P < 0. 05) . The expression of IL⁃2R and IL⁃23 in the placenta of preeclampsia was higher difference (P < 0. 05) . However , there was no statistically significant difference in the expression of IL⁃23 and IL⁃than that of normal pregnant women , with a statistically significant 2R in the decidua of the two groups (P > 0. 05) . Conclusion Compared with normal pregnant women , there are differences in the expression levels of IL⁃10 , IL⁃23 , and IL⁃2R in preeclampsia pregnant women . This difference may be related to Th17/Treg cellular immune imbalance , suggesting that Th17/Treg immune imbalance mediated changes in related cytokines may be involved in the pathogenesis of preeclampsia .

Objective:To study the short-term clinical outcomes of different courses of antenatal corticosteroids (ACS) for preterm twins.Methods:From January 2017 to December 2021, preterm twins with gestational age (GA) 24-34 weeks admitted to the neonatal ward of our hospital and received ACS were retrospectively studied. The infants were assigned into single-course group, partial-course group and multiple-course group according to ACS courses. The short-term clinical outcomes were compared among the groups. SPSS software version 25.0 was used for statistical analysis.Results:A total of 286 infants were enrolled in this study, including 128 in single-course group, 89 in partial-course group and 69 in multiple-course group. Compared with single-course group, the risks of neonatal respiratory distress syndrome (RDS) in both partial-course group ( OR=2.332, 95% CI 1.028-5.293, P=0.043) and multiple-course group ( OR=3.872, 95% CI 1.104-13.584, P=0.034) were higher. The birth length in multiple-course group ( β=-0.016, 95% CI -0.029 - -0.002, P=0.024) was lower than single-course group. Conclusions:The risks of neonatal RDS in preterm twins are higher in partial-course and multiple-course of ACS. A full course of ACS should be used to prevent neonatal RDS until further evidence of effectiveness is available.

Objective To explore the effect of continuous nursing intervention on limb function and nursing quality after proximal femoral nail antirotation (PFNA) internal fixation for femoral intertrochanteric fracture in the elderly. Methods From February, 2017 to November, 2018, 100 elderly patients with femoral intertrochanteric fracture who underwent PFNA internal fixation in our hospital were randomly divided into control group (n = 50) and observation group (n = 50), who accepted routine nursing and continuous nursing respectively for three months. They were assessed with Harris score and visual analogue scale for pain (VAS) before and after the intervention. The postoperative nursing effect was compared. Results The Harris score increased in both groups after the intervention (t > 45.98, P < 0.001), and increased more in the observation group than in the control group (t = 15.03, P < 0.001). The VAS score decreased in both groups after the intervention (t > 16.33, P < 0.001), and decreased more in the observation group than in the control group (t = 9.749, P < 0.001). The effect of nursing was better in the observation group than in the control group (Z = -2.272, P = 0.023). Conclusion Continuous nursing intervention can significantly improve the limb function and nursing satisfaction of elderly patients with femoral intertrochanteric fracture after PFNA.

Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.