Objective To study the clinical value of esophageal stent placement with radiation therapy for the middle-late pa-tients with esophageal cancer.Methods To perform esophageal stent placement and radiation therapy for the middle-late 35 pa-tients,and to perform radiation therapy for the middle-late 37 patients,then observe the clinical curative effects.Results The treat-ment group were significantly alleviated with dysphagia symptom after operation,which 32 cases sticked the entire radiation,ac-counting for 91.4%,no one can′t complete the treatment because of nutritional status reason.Survival time of one month after ra-diotherapy was up to 100.0%,and survival time of six months was 85.7% (30/35).But the contrast group with dysphagia symp-tom were aggravated or no relief,and needed parenteral nutrition.There were 23 cases to complete the entire radiation,accounting for 62.2%,and 5 cases happened esophageal tracheal fistula.Survival time of one month after radiotherapy was 83.8%(31/37),and survival time of six months was 62.2% (23/37).Two groups of cases in radiotherapy resistance difference was statistically signifi-cant,one month and six months of survival time were statistically significant (all P <0.05 ).Conclusion Esophageal stent place-ment with radiotherapy is more efficient than only radiation therapy to the middle-late patients with esophageal cancer.

To explore the influencing factors of major birth defects.The children of 0 -3 years and their mother from six different districts were surveyed from November 2009 to December 2009.The incidence rate was 134.27/10 000 (493/36 716)in 6 counties. And the first five birth defects were as follows:congenital heart disease,neural tube defects,cheilopalatognathus,polydactylia and hypophrenia.The risks and protective factors of the first 5 birth defects were different.Anamnesis of birth defects and defective children from relatives,multiple pregnancy & birth and intake of antipyretic analgesics during pregnancy were the common risk factor for the first 5 birth defects.The key points for the prevention of birth defects are to reinforce the pre-pregnancy guidance,the screening and evaluation of risk factors and disease prevention during pregnancy.

Objective To understand the status of knowledge and attitude of schistosomiasis control among the human populafion in schistosomiasis transmission-controlled area of Changqiu mountainous areas.Methods The subjects were selected by the random cluster sampling method among residents and students in these alias,then they were investigated by questionnaire.Resuits A total of 150 residents and 209 students were selected.There were 60% of the residents whose awareness rates of the knowledge on schistosomiasis control were above 90%.The correction rates of the questions in residents were between 99.30% and 100%.and the awareness rates about the questionswhether re-infection would occure after schistosomiasis was cured and the remedy for schistosomiasisof female adults were both 75.40%.The correction rates of the two question8 on attitude and behaviour of schistosomiasis control in adults were above 80.00%.In students'questionnaires.the awareness rates of knowledge on schistosomiasis control were above 90%.except the two questions on the shape of the snailand the infection-risk months of schistosomiasis.The correction rates of attitude and behaviour of schistosomiasis control were aslo above 80%.Conclusion The correction rates of knowledge,attitude and behaviour of schistosomiasis control of adults and students have reached the national goal of schistosomiasis control in 2008.

Objective To investigate the effect of blood pressure variability on early neurological deterioration (END) in patients with acute minor stroke or high-risk transient ischemic attack (TIA).Methods Consecutive patients with acute minor stroke or high-risk TIA admitted to the Department of Neurology, the Affiliated Hospital of Yangzhou University between March 2017 and December 2018 were enrolled prospectively. Minor stroke was defined as the National Institutes of Health Stroke Scale (NIHSS)score ≤3, and high-risk TIA was defined as ABCD2 score ≥4. The blood pressure monitored within 72 h after admission was analyzed. The mean, maximum (max), range (max-min), standard deviation (SD), and coefficient of variation (CV) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated. END was defined as highest NIHSS score increase ≥ 2 at re-evaluation within 72 h after admission compared with the baseline score. Multivariate logistic regression analysis was used to determine the independent correlation between blood pressure variability parameters and END. Results A total of 123 patients were enrolled in the study, including 54 females (43. 90％) and 69 males (56. 10％), aged (63. 74 ± 11. 94) years. Thirty-nine (31. 71％) of them were high-risk TIA, 84 (68. 29％) were minor strokes. END occurred in 33 patients (26. 8％) within 72 h on admission. Univariate analysis showed that there were significant differences in age, gender, white blood cell count, C-reactive protein, and SBPmax-min , SBPSD ,SBPCV, DBPmax-min , DBPSD , and DBPCV between the END group and the non-END group (all P < 0. 05).Multivariate logistic regression analysis showed that after adjusting for confounding factors, SBPmax-min (odds ratio [OR] 1. 019, 95％ confidence interval [CI] 1. 001-1. 038), SBPSD (OR 1. 099, 95％ CI 1. 005-1. 201),SBPCV(OR 1. 320, 95％ CI 1. 124-1. 550), DBPmax-min (OR 1. 065, 95％ CI 1. 017-1. 114), DBPSD (OR 1. 492,95％ CI 1. 186-1. 877), and DBPCV(OR 1. 543, 95％ CI 1. 263-1. 886) were the independent risk factors for END within 72 h on admission in patients with acute minor stroke or high-risk TIA. Conclusion Multiple blood pressure variability parameters are significantly independently correlated with the risk of END in patients with acute minor stroke or high-risk TIA.

Objective To observe the clinical efficacy and safety of 5% imiquimod cream in topical treatment of anogenital warts. Methods A randomized, double-blind, parallel placebo-controlled clinical study was conducted. Patients with anogenital warts were instructed to apply the test drug topically and then clean the drug with water 6 ~ 8 hours later, three times a week for 8 weeks. Patients whose warts cleared completely were followed up for one month to determine recurrence rates. Results Two hundred and thirty-one patients with anogenital warts were enrolled in this trial. One hundred and sixteen patients were randomly selected to receive 5% imiquimod cream; and the other receive placebo cream. For 2, 4, 6, 8 weeks, the cure rates were 8.41%, 30.84%, 49.53%, 61.68%, respectively in the study group, and 2.68%, 7.14%, 16.07%, 24.11%, respectively in the control group (P

Objective To investigate the correlation between blood pressure variability (BPV) and early neurological deterioration (END) in patients with acute anterior circulation large artery atherosclerotic (LAA)stroke. Methods From January 2015 to June 2018, consecutive patients with anterior circulation acute ischemic stroke admitted to the Department of Neurology, the Affiliated Hospital of Yangzhou University were enrolled prospectively. According to the etiological classification, they were divided into LAA group and non-LAA group. By monitoring the blood pressure within 72 h of hospitalization, the mean, maximum (max)and minimum (min) values, and the difference between max and min (max-min), standard deviation (SD),and coefficient of variation (CV; CV = SD × 100/mean) were calculated. END was defined as the highest score of the National Institutes of Health Stroke Scale (NIHSS) within 72 h of admission increased by ≥2than the baseline. Multivariate logistic regression analysis was used to determine the correlation between BPV parameters and END. Results A total of 271 patients with anterior circulation acute ischemic stroke were enrolled, including 101 females (37. 3％) and 170 males (62. 7％), with an average age of 64. 99 ± 11. 51 years. There were 95 patients (35. 1％) with LAA and 176 (64. 9％) with non-LAA. In the LAA group and non-LAA group, 36 patients (37.9％) and 50 patients (28.4％) developed END respectively. The comparison between END patients and non-END patients in the LAA group showed that there were significant differences in age, sex, diabetes mellitus, baseline NIHSS score and C-reactive protein, as well as SBPmax , SBPmax-min , SBPSD , SBPCV, DBPmax , DBPmax-min , DBPSD , and DBPCV in BPV indices (all P < 0. 05).Multivariate logistic regression analysis showed that many BPV indices were the independent risk factors for END, including SBPmax (odds ratio [OR] 1. 027, 95％ confidence interval [CI] 1. 003-1. 052; P = 0. 027),SBPmax-min (OR 1. 041, 95％CI 1. 015-1. 068; P = 0. 002), SBPSD (OR 1. 177, 95％ CI 1. 048-1. 322; P =0. 006), SBPCV (OR 1. 226, 95％ CI 1. 036-1.451; P = 0. 018), DBPmax (OR 1. 073, 95％ CI 1. 017-1. 133;P = 0. 010), DBPmax-min (OR 1. 107, 95％CI 1. 044-1. 174; P = 0. 001), DBPSD (OR 1. 693, 95％CI 1. 268- 2. 260; P < 0. 001), and DBPCV(OR 1. 726, 95％CI 1. 311-2. 271; P < 0. 001). In the non-LAA group, there were no significant association between all BPV parameters and the occurrence of END. Conclusion BPV was significantly correlated with END in patients with anterior circulation LAA.

ObjectiveTo observe the therapeutic effect of Wang's Yijing decoction combined with conventional therapy on the treatment of polycystic ovary syndrome （PCOS） with kidney deficiency and phlegm-dampness syndrome and its regulating effect on the intestine-brain axis. MethodThe 132 patients from the gynecological clinic of Shanxi Bethune Hospital were randomly assigned into a control group and an observation group， with 66 patients in each group. The patients in the control group were treated with drospirenone and ethinylestradiol tablets and metformin tablets， and those in the observation group were administrated with Wang's Yijing decoction on the basis of the therapy in the control group. The treatment in both groups lasted for 3 menstrual cycles. The changes in menstrual blood volume， color， and texture， as well as that in the menstrual cycle before and after treatment were scored. Further， the Rosenfield， hirsutism， and kidney deficiency and phlegm-dampness syndrome were scored before and after treatment. Pelvic ultrasound was performed before and after treatment to compare the bilateral ovarian volume. The levels of anti-mullerian hormone （AMH）， estradiol （E₂）， luteinizing hormone （LH）， follicle-stimulating hormone （FSH）， testosterone （T）， dihydrotestosterone （DHT）， and sex hormone-binding globulin （SHBG） were measured before and after treatment， and the free androgen index （FAI） was calculated. After the fasting insulin and fasting blood glucose were examined before and after treatment， the homeostatic model assessment of insulin resistance （HOMA-IR） was calculated. The levels of ghrelin， glucagon-like peptide-1 （GLP-1）， peptide tyrosine-tyrosine （PYY） in serum and short-chain fatty acids （SCFAs） in fresh stool were measured before and after treatment. ResultThe treatments in both groups lowered the scores of irregular menstruation， Rosenfield， hirsutism， and kidney deficiency and phlegm-dampness syndrome （P<0.01）， and the scores in the observation group were lower than those in the control group （P<0.01）. After treatment， the T， DHT， FAI， AMH， E₂， LH， and FSH levels lowered （P<0.01）， while the SHBG level elevated （P<0.01）. In addition， the AMH， E₂， LH， T， DHT， and FAI in the observation group were lower than those in control group， while the SHBG level presented an opposite trend （P<0.01）. After treatment， the bilateral ovarian volume and HOMA-IR of the two groups decreased （P<0.01）， and were lower in the observation group than in the control group （P<0.05， P<0.01）. The treatments in both groups elevated the levels of ghrelin， GLP-1， PYY， and SCFAs （P<0.01）， which were higher in the observation group than in the control group （P<0.01）. After treatment， the recovery rate in the observation group was 65.57% （40/61）， which was higher than 44.83% （26/58） in the control group （χ²=5.180， P<0.05）. ConclusionWang's Yijing decoction combined with conventional western medicine treatment can regulate the intestine-brain axis， endocrine and metabolic disorders， and sex hormones， adjust the menstrual cycle， and alleviate clinical symptoms， demonstrating good clinical effect for the PCOS patients with kidney deficiency and phlegm dampness syndrome.

Objective: To explore the relationships of neutrophil gelatinase-associated lipocalin (NGAL) with severity of skin lesions in children with psoriasis and peripheral neutrophil count, and to evaluate in vitro effect of NGAL on expression of tumor necrosis factor-α (TNF-α) and interleukin-22 (IL-22) by a human immortalized keratinocyte cell line HaCaT. Methods: From January 1st 2017 to December 31st 2018, 98 children who newly developed psoriasis were enrolled from Department of Dermatology of 6 hospitals in China, including 51 males and 47 females. Their age was 7.00 ± 2.99 years (range: 3-14 years) , and their course of disease was 7.4 ± 5.85 days (range: 3-28 days) . The serum level of NGAL was detected in all the patients before and two weeks after treatment, and the relationships of NGAL with psoriasis area and severity index (PASI) scores and peripheral neutrophil count were evaluated. Western blot analysis and reverse-transcription (RT) -PCR were performed to determine the protein and mRNA expression of TNF-α and IL-22 in HaCaT cells, respectively, after 12-hour treatment with NGAL at concentrations of 0 (control group) , 0.125, 0.25, 0.5, 1 mg/L. Statistical analysis was carried out with SPSS 16 software. by using t test and one-way analysis of variance. Results: After 2-week treatment, the PASI score, neutrophil count and NGAL level in children with psoriasis significantly decreased (1.80 ± 1.19, [6.16 ± 0.76] × 10⁹/L, 90.86 ± 0.75 μg/L, respectively) compared with those before the treatment (10.38 ± 3.42, [11.01 ± 2.85] × 10⁹/L, 113.48 ± 21.26 μg/L, respectively; t = 31.42, 18.34, 16.37 respectively, all P < 0.001) . Before the treatment, the serum level of NGAL in the patients was positively correlated with the PASI score and peripheral neutrophil count (r = 0.918, 0.799 respectively, both P < 0.05) . The mRNA and protein expression of IL-22 in HaCaT cells significantly differed among these groups treated with different concentrations of NGAL (F = 176.31, 296.96 respectively, both P < 0.001) , so did the mRNA and protein expression of TNF-α (F = 193.28, 318.80 respectively, both P < 0.001) . Additionally, the protein and mRNA expression of IL-22 and TNF-α in HaCaT cells was significantly higher in the 0.125-, 0.25-, 0.5- and 1-mg/L NGAL group than in the control group (all P < 0.05) . The NGAL level was positively correlated with the protein and mRNA expression of TNF-α and IL-22 in HaCaT cells (all P < 0.05) . Conclusions The serum level of NGAL was high in children with psoriasis, and positively correlated with severity of skin lesions and peripheral neutrophil count. NGAL can upregulate the expression of TNF-α and IL-22 in HaCaT cells in vitro.