Pancreatic neuroendocrine neoplasms (pNENs) are clinically rare,however,it shows an in creasing trend recent years.Surgical management,such as radical resection or debulking,plays an important role in this field.Different procedures can be applied to tumors with different types,locations,and developing stages.The optimal clinical management of pNENs involves a multidisciplinary approach in order to improve prognosis.

Objective To establish a suitable evaluation index system to track implementation effect of clinical research program.Methods Delphi method was used to creat the evaluation index system.The weighted average method was adopted to determine the weight of each index.Results After two rounds of expert consultation,twenty seven evaluation indices were selected,including three first-class indices,eight second-class indices and sixteen third-class indices,and the weight of each index was determined.Conclusions The evaluation index system reflects the purpose of tracking clinical research to a certain extent.This index system is simple and easy to be used.

Objective:To analyze the risk factors of intracranial hemorrhage after implanting 125-iodine seeds for brain tumors.Methods:A total of 234 patients with intracranial tumors receiving treatment of 125-iodine seeds from March, 2013 to November, 2020 were retrospectively analyzed. Patients were divided into bleeding group and non-bleeding group according to whether postoperative intracranial hemorrhage was reported. Univariate and multivariate analysis was performed by logistic regression to determine the independent risk factors of intracranial hemorrhage.Result:A total of 22 cases (9.4%) reported postoperative intracranial hemorrhage in 234 patients treated with 125-iodine seeds. Univariate analysis showed that the type of tumor and the history of anti-angiogenic drug within one month were possible risk factors ( P<0.1). Multivariate logistic regression analysis showed that anti-angiogenic drug within one month was the independent risk factor for intracranial hemorrhage ( P<0.05). Conclusions:The application of anti-angiogenic drugs within one month is the independent risk factor of intracranial hemorrhage with 125-iodine seeds for the treatment of brain tumors.

Objective:To compare the efficacy of ulnar Z-shaped shortening osteotomy combined with arthroscopic deep suture anchor repair of the triangular fibrocartilage complex (TFCC) and ulnar Z-shaped shortening osteotomy alone in the treatment of ulnar impaction syndrome with moderate or severe distal radioulnar joint instability.Methods:A retrospective cohort study was conducted to analyze the clinical data of 30 patients with ulnar impaction syndrome accompanied by moderate or severe distal radioulnar joint instability, who were admitted to Affiliated Hospital of Qingdao University from January 2016 to June 2023, including 16 males and 14 females, aged 27-58 years [(42.4±9.9)years]. All the patients presented with positive ulnar variance and TFCC type IB injury, with the deep layer of TFCC affected. Fifteen patients were treated with Z-shaped shortening osteotomy of the ulna alone (osteotomy alone group), while the other 15 patients received Z-shaped shortening osteotomy of the ulna combined with arthroscopic suture anchor repair of the deep layer of TFCC (osteotomy combined with repair group). The operation time, intraoperative blood loss, and length of ulnar shortening were compared between the two groups. The forearm rotation, ulnar-radial deviation angle, palmar-dorsal flexion angle, grip strength, visual analogue scale (VAS), patient-rated wrist evaluation (PRWE) score, modified Mayo wrist score, and disabilities of the arm, shoulder, and hand (DASH) questionnaire score were assessed preoperatively, at 6 and 12 months postoperatively, and at the last follow-up. The incidence of postoperative complications was recorded.Results:The patients were followed up for 6-24 months [(15.8±4.9)months]. The operation time in the osteotomy combined with repair group was 3.0 (2.3, 3.0)hours, longer than 1.5 (1.3, 2.0)hours in the osteotomy alone group ( P<0.01). There were no significant differences in intraoperative blood loss and the length of ulnar shortening between the two groups ( P>0.05). There were no significant differences in forearm rotation, ulnar-radial deviation angle, palmar-dorsal flexion angle, grip strength, VAS, PRWE score, modified Mayo wrist score, and DASH score between the two groups preoperatively ( P>0.05). At 6 and 12 months postoperatively, and at the last follow-up, the forearm rotation degrees in the osteotomy combined with repair group were (130.3±8.8)°, (135.2±7.9)°, and (141.9±6.9)°, greater than (120.5±9.4)°, (123.7±10.2)°, and (130.9±8.5)° in the osteotomy alone group; the ulnar-radial deviation angles in the osteotomy combined with repair group were 23.0 (23.0, 26.5)°, 33.0 (30.0, 36.0)°, and 36.0 (32.5, 41.5)°, greater than 22.0 (20.0, 23.0)°, 23.0 (23.0, 28.0)°, and 25.0 (23.0, 33.5)° in the osteotomy alone group ( P<0.05 or 0.01). In the osteotomy combined with repair group, the palmar-dorsal flexion angles at 12 months postoperatively and at the last follow-up were (125.8±10.8)° and (132.9±16.8)°, greater than those in the osteotomy alone group [(99.1±15.7)° and (121.2±17.4)°] ( P<0.01), while there was no significant difference in the palmar-dorsal flexion angle between the two groups at 6 months postoperatively ( P>0.05). In the osteotomy combined with repair group, the grip strength at 6 months postoperatively was (14.6±1.0)N, greater than (12.8±1.8)N in the osteotomy alone group ( P<0.05), while there was no significant difference in grip strength between the two groups at 12 months postoperatively and at the last follow-up ( P>0.05). At 6, 12 months postoperatively, and at the last follow-up, the VAS scores in the osteotomy combined with repair group were (4.3±1.9)points, (2.7±1.1)points, and (2.1±0.7)points, lower than (6.5±2.5)points, (4.7±1.4)points, and (4.3±0.9)points in the osteotomy alone group; the PREW scores were (57.6±4.1)points, (47.3±2.4)points, and (35.0±3.4)points, lower than (67.8±4.5)points, (53.1±4.4)points, and (43.5±4.1)points in the osteotomy alone group ( P<0.05 or 0.01). The modified Mayo wrist scores in the osteotomy combined with repair group at 6, 12 months postoperatively, and at the last follow-up were (78.3±2.9)points, (80.1±3.0)points, and (83.5±3.9)points, higher than those in the osteotomy alone group [(69.0±4.3)points, (75.5±2.9)points, (78.8±2.4)points] ( P<0.01). The DASH scores in the osteotomy combined with repair group at 12 months postoperatively and at the last follow-up were (35.8±4.6)points and (28.4±5.4)points, lower than (43.3±5.0)points and (34.2±4.4)points in the osteotomy alone group ( P<0.01), while there was no significant difference in DASH scores between the two groups at 6 months postoperatively ( P>0.05). In both groups, forearm rotation, ulnar-radial deviation angle, palmar-dorsal flexion angle, grip strength, and modified Mayo wrist scores at all time points postoperatively were all higher than the preoperative values ( P<0.05), while the postoperative VAS, PREW, and DASH scores were lower than the preoperative values ( P<0.05), with statistically significant differences among different time points postoperatively ( P<0.01). The incidence of postoperative complications in the osteotomy combined with repair group was 6.7% (1/15), lower than 46.7% (7/15) in the osteotomy alone group ( P<0.05). Conclusion:Compared with the ulnar Z-shaped shortening osteotomy alone, ulnar Z-shaped shortening osteotomy with arthroscopic suture anchor deep repair of TFCC has the advantages of increased wrist range of motion, reduced pain, improved function, and lower incidence of complications, etc in treating ulnar impaction syndrome with moderate or severe instability of the distal radioulnar joint.

Objective To verify the expression of long non-coding RNA(LncRNA) TCONS_00023867 in pancreatic cancer tissue and cells,and to explore its effects on cell proliferation,invasion and migration in pancreatic cancer cells.Methods The expression of lncRNA TCONS_00023867 in human pancreatic cancer tissues,adjacent non-cancer tissues,pancreatic cancer cells(Capan-2,AsPC-1,BxPC-3,MIAPaCa-2,PANC-1) and pancreatic normal duct epithelial cell (HPDE6c-7) was detected by quantitative real-time PCR (qRT-PCR).LncRNA TCONS_00023867 over-expression plasmid and its control plasmid PEX-3 were transfected in Capan-2 and PANC-1 cells.Then,the abilities of cell proliferation,invasion and migration were determined by using clone formation assay,CCK-8 assay and Transwell assay,respectively.Furthermore,the expression of p53 protein was examined by Western blot.Results The expression of IncRNA TCONS_00023867 in pancreatic cancer tissues was significantly lower than that in the matched adjacent pancreatic cancer tissue(△Ct value 13.64±0.55vs 8.64± 0.38,P＜0.001).Over-expression of TCONS_00023867,the experimental plate clone count of Capan-2 and PANC-1 cells were respectively lower than that in the empty plasmid vector PEX-3 group (181.3±4.667 vs 227.3± 9.207,P=0.011 2),(86.0±4.933 vs 167.2±2.603,P=0.000 1).The proliferation ability of Capan-2 and PANC-1 was significantly reduced compared with that of the empty plasmid vector PEX-3 group.The migration ability of Capan-2 and PANC-1 was significandy reduces compared with that of the group of empty plasmid vector PEX-3 (57.6±6.809 vs 124.6±8.548,P=0.003),(47.40±7.061 vs 105.2±10.28,P=0.001 7).The invasion ability of Capan-2 and PANC-1 was significantly reduced compared with that of the empty plasmid vector PEX-3 group (46.0± 5.033 vs 120.7±7.055,P=0.001),(64±8.327 vs 118.0±11.53,P=0.019 2).Through western blot experiment,the expression of p53 in Capan-2 and PANC-1 was higher than that in the group of empty plasmid vector PEX-3 (2.192± 0.077 3 vs 1.007±0.018 8,P=0.000 1),(1.816±0.163 vs 0.988±0.012 16,P=0.007 2).Conclusions The level of TCONS_00023867 is decreased in pancreatic cancer tissues and cells.Overexpression of TCONS_00023867 decreases cell proliferation,invasion and migration in pancreatic cancer ceils through increasing the level of p53.

A 3-week practice-oriented training course on chronic obstructive pulmonary disease (COPD) management was conducted in December 2020, 34 primary care physicians from township or community health service centers attended the course. The impact of the training course on the knowledge levels of COPD management was evaluated with a questionnaire survey, the questionnaire contained the knowledge of COPD and its management. The survey showed that before the training, the participants had low knowledge levels on the definition of COPD and its risk factors; 67.6% (23/34) were not aware of COPD-related guidelines and new developments, and 17.6%(6/34) had conducted COPD follow-up assessments, pulmonary rehabilitation, and health education; only 8.8% (3/34) had used the improved British Medical Research Council Dyspnea Index (mMRC) and the chronic obstructive pulmonary disease assessment test (CAT) for patient self-assessment; there was no pulmonary function instrument in their units, and only 3 doctors (8.8%) had previously participated in pulmonary function training and knew indications and contraindications of the pulmonary function test, and complete report interpretation; all participants were unable to use common inhalation devices and master inhalation techniques completely and correctly; 11.8% (4/34) had assessed patients′ handling inhalation devices and performing inhalation. After the training, the knowledge levels of COPD clinical features, lung function and inhalation technique were significantly improved, and the scores were significantly increased compared with those before the training ( P<0.001). The study shows that primary care physicians have insufficient knowledge and management skill of COPD. The practice-oriented training can significantly improve the knowledge and skills of primary care physician for COPD management in the community.

Objective:To compare the accuracy of influenza-like illness (ILI) surveillance by automatic computer analysis based on electronic medical records and by doctor’s report.Methods:A total of 3 542 patients who presented to Yichang Central Hospital fever clinic, respiratory department or emergency department between April to October 2019 with an ICD-10 code for acute respiratory illness (J00-J22) and complete electronic medical information of ILI related syndromes were drawn as the study sample. Taking the classification of the study sample according to the ILI case definition by influenza surveillance professionals as the gold standard, draw the receiver operating characteristic (ROC) curve and calculate sensitivity, specificity, diagnostic consistency to compared the accuracy of ILI surveillance by automatic computer analysis and by doctor's report.Results:Median age of 3 542 cases was 30 (24, 38) years old; 1 179 cases (33.29%) compliance with the case definition, ILI reported by doctors was 1 306 cases (36.87%), and computer automatic identification ILI were 1 150 cases (32.47%); 1 391 (39.27%) cases were men. The results of automatic computer analysis and doctor report consistency of kappa values with gold standard judgment were 0.97 and 0.66 respectively; area under the ROC curve was 0.98 and 0.84, respectively. And the sensitivity and specificity of automatic computer analysis were higher than that of doctor's report (all P values were <0.001), the sensitivity was 96.95% and 82.27%, and the specificity was 99.70% and 85.78%, respectively. Conclusion:The automatic computer analysis based on electronic medical records can identified ILI cases with good sensitivity and specificity in ILI case surveillance.

Objective:To compare the accuracy of influenza-like illness (ILI) surveillance by automatic computer analysis based on electronic medical records and by doctor’s report.Methods:A total of 3 542 patients who presented to Yichang Central Hospital fever clinic, respiratory department or emergency department between April to October 2019 with an ICD-10 code for acute respiratory illness (J00-J22) and complete electronic medical information of ILI related syndromes were drawn as the study sample. Taking the classification of the study sample according to the ILI case definition by influenza surveillance professionals as the gold standard, draw the receiver operating characteristic (ROC) curve and calculate sensitivity, specificity, diagnostic consistency to compared the accuracy of ILI surveillance by automatic computer analysis and by doctor's report.Results:Median age of 3 542 cases was 30 (24, 38) years old; 1 179 cases (33.29%) compliance with the case definition, ILI reported by doctors was 1 306 cases (36.87%), and computer automatic identification ILI were 1 150 cases (32.47%); 1 391 (39.27%) cases were men. The results of automatic computer analysis and doctor report consistency of kappa values with gold standard judgment were 0.97 and 0.66 respectively; area under the ROC curve was 0.98 and 0.84, respectively. And the sensitivity and specificity of automatic computer analysis were higher than that of doctor's report (all P values were <0.001), the sensitivity was 96.95% and 82.27%, and the specificity was 99.70% and 85.78%, respectively. Conclusion:The automatic computer analysis based on electronic medical records can identified ILI cases with good sensitivity and specificity in ILI case surveillance.

OBJECTIVE: To investigate the preventive effect of rock salt aerosol on the development of silicosis in rats. METHODS: The specific pathogen free adult male SD rats were randomly divided into normal control group, rock salt control group, silicosis model group and rock salt intervention group, 18 rats in each group. Rats in the silicosis model group and the salt rock intervention group were treated with silica dust at the concentration of 2 000.0 mg/m~3 by dynamic dusting method for 3 hours daily. Rats in the rock salt control group and the rock salt intervention group inhaled the rock salt aerosols with the mass concentration of 20.0 mg/m~3 for 30 minutes daily. The normal control group was not treated with the dust or rock salt aerosol. At the time points of 14, 28 and 56 days after exposure to dust or rock salt aerosol, 6 rats were randomly selected from each group and samples were collected. The pathological change of lung was observed, the total cell count in the bronchoalveolar lavage fluid(BALF) was performed, the enzyme-linked immunosorbent assay was used to detect the change of transforming growth factor-β(TGF-β) in BALF, surfactant D(SP-D) and superoxide dismutase(SOD) in lung tissue. RESULTS: The results of hematoxylin-eosin and Masson staining showed that the inflammatory changes of lung tissue and the pulmonary interstitial fibrosis in the rock salt intervention group were less severer than that in the silicosis model group. At 14, 28, and 56 days after dust exposure, the total cell counts in BALF and SP-D levels in lung tissue of rats in silicosis model group and rock salt intervention group were higher(P<0.05), the SOD activities in lung tissue were lower(P<0.05), as well as the TGF-β levels in BALF in silicosis model group were higher(P<0.05),compared with the normal control group and rock salt control group. The total cell counts and TGF-β levels in BALF, and SP-D levels in lung tissue of rock salt intervention group were lower(P<0.05), the SOD activities in lung tissue were higher(P<0.05), compared with the silicosis model group. CONCLUSION: Rock salt aerosol intervention may delay the pathogenesis of silicosis by improving the inflammatory response, regulating oxidative stress and reducing interstitial fibrosis of lungs.