OBJECTIVE: To evaluate the clinical efficiency of recombinant adenovirus p53 injection (rAd-p53) combining chemotherapy in the treatment of malignant body cavity effusion. METHODS: 50 cases with malignant body cavity effusion were randomly divided into 2 groups. The treatment group were given intracavitary administration of rAd-p53 1 ? 1012VP after puncture drainage, 48h later which were given intracavitary administration of 60mg/m2 cisplatin once a week for 3～4 weeks. The control group was given the same intracavitary therapy as the treatment group but without rAd-p53 therapy. RESULTS: The total effective rates of the treatment group and the control group were 85.7% and 51.7%(P

Objective: To examine the status of bullying behaviors and psychological resilience of primary school students and the relationship between the two, and to provide references for related interventions. Methods: Olweus bullying questionnaire and adolescent psychological resilience scale were used to select students in grades 4-6 for questionnaire survey. Results: Primary school students who were bullied, bullied others, double-involved and uninvolved accounted 33.3%, 48.7%, 15.3%, and 2.7%. There were statistically significant differences in bullying in different dimensions of different genders, grades, and previous suicidal thoughts (P<0.05); there were statistically significant differences in the bullied status of only children, divorced parents, and different caregivers (t/F=3.64，2.65，6.62，P<0.05); The status of bullying behavior of students in the class was better than that of ordinary students (t=-2.18, P<0.05); senior students have a higher level of positive cognition (F=8.71, P<0.05); mental toughness of urban students better than rural areas (t=-2.20, P<0.05); students with divorced parents had poor levels of emotional control, family support, and psychological toughness (t=-4.60，-3.92，-3.44，P<0.05); class cadres focused on focus, positive cognition, family support, interpersonal assistance, and psychological resilience were better than ordinary students (t=5.19，6.43,5.64,4.13，6.58，P<0.05); students with parental care had better levels of target concentration, emotional control, family support, interpersonal assistance, and psychological resilience (t=4.59，8.68，8.76，12.35，13.45，P<0.05); the level of psychological resilience of students was low (t=15.90，P<0.05). Correlation analysis shows that there was a negative correlation between bullying behavior and psychological resilience of all pupils (P<0.01), regression analysis showed that bullying behavior may had a negative prediction of mental resilience (F=128.37, R2=0.12, P<0.01). Conclusion The current situation of bullying behavior and mental resilience of grade 4-6 students is worrisome, and it is urgent to improve the current situation of bullying and psychological resilience of primary school students.

Purpose: Seroma formation is a common complication in breast cancer patients undergoing mastectomy, and it negatively affects patient recovery after surgery. The present study aimed to evaluate a simple method using fascia suture technique to fix the flap and reduce the incidence of seroma. Methods: A single-center, prospective, randomized controlled trial was carried out among 160 patients who had undergone mastectomy from May 2018 to September 2019. All patients were randomly divided into the fascia suture group (n = 80) or control group (n = 80) and were followed up for at least 3 months for the assessment of immediate and late complications after surgery. Results: No significant differences were observed between the 2 groups with regard to the basic characteristics. Duration of surgery in the fascia suture group was longer by about 6 minutes compared with that in the control group (114.93 ± 13.67 minutes vs. 108.81 ± 15.20 minutes, p = 0.008). The fascia suture group had a shorter duration of drain placement (10.99 ± 3.26 days vs. 13.85 ± 5.37 days, p < 0.001), a smaller volume of the total drainage (460.95 ± 242.92 mL vs. 574.83 ± 285.23 mL, p = 0.007), and the first 3-day drainage (224.96 ± 101.01 mL vs. 272.3 ± 115.47 mL, p = 0.006), compared with the control group. The incidence of seroma formation (G2 or G3) was significantly lower in the fascia suture group compared with the control group (28.8% vs. 12.5%, p = 0.033). Besides, there was no statistical difference between the 2 groups in the assessment of other complications, including postoperative pain, hematoma, surgical site infections, flap necrosis, and skin dimpling (all p > 0.050). Conclusion The fascia suture technique is a simple and effective method for reducing seroma formation and should be used to prevent seroma formation after mastectomy.

Objective:To analyze the impact of gender on prognosis in patients with primary hepatocellular carcinoma (HCC) after hepatectomy.Methods:The data of 1 796 patients with HCC who underwent liver resection at the Guangxi Medical University Cancer Hospital from January 2010 to December 2016 were retrospectively analyzed. There were 1 548 males and 248 females, the average age were 49.6 years. Patients were followed up for recurrence and survival. After propensity score matching, the postoperative survival rates of male and female patients were compared. Univariate and multivariate Cox regression was used to analyze independent factors affecting prognosis of patients with HCC after hepatectomy. The age and menopause were analyzed by subgroup analyses.Results:The 1-, 3- and 5-years cumulative overall and recurrence-free survival rates of male patients were significantly lower than that of female patients (all P<0.05). Multivariate analysis showed that female was an independent protective factor affecting postoperative recurrence ( HR=0.777, 95% CI: 0.615-0.982) and overall survival ( HR=0.669, 95% CI: 0.520-0.856). Using a cut-off value of 50 years old, the patients were divided into <50 years old ( n=915) and ≥50 years old ( n=881). In patients who were less than 50 years old, the 1-, 3- and 5-years cumulative overall and recurrence-free survival rates of male patients were significantly lower than those of female patients (all P<0.05). In patients ≥50 years old, there were no significant difference in the cumulative overall and recurrence-free survival rates between male and female patients (all P>0.05). Female patients were then divided into the postmenopausal group ( n=152) and the premenopausal group ( n=96). There were no significant differences in the cumulative overall and cumulative recurrence-free survival rates between the two groups ( P>0.05). Conclusion:The prognosis of female patients with HCC after hepatectomy was significantly better than that of male patients.

Objective: To investigate the mid-term outcomes of the dual mobility total hip prosthesis in primary total hip arthroplasty. Methods: A total of 101 patients who underwent primary total hip arthroplasty with dual mobility total hip prosthesis from May 2010 to March 2013 were enrolled in the present study with complete follow-up information. There were 56 females and 45 males with the mean age of 66.36 years (rang from 58 to 77 years). There were 35 patients with femoral neck fracture, 33 patients with femoral head necrosis, 10 patients with hip osteoarthritis, 18 patients with secondary osteoarthritis to hip dysplasia and 5 patients with ankylosing spondylitis. The dual mobility total hip prosthesis was used for all 101 patients by the posterior-lateral approach of hip joint. Harris hip score was used to evaluate the clinical effects. Radiographic analysis was also performed to evaluate the biological fixation effects of the prosthesis, dislocation of the prosthesis, osteolysis and migration of the acetabular cup. Results: The mean operation duration was 80.68±6.59 min (range from 70 to 90 min). The average blood loss during the operation was 180.67±18.76 ml (range from 150 to 200 ml). All incisions were healed at the first stage. All patients were followed up with an average of 65±3 months (range from 62 to 75 months). Harris hip score improved from 56.70±16.71 before surgery to 94.26±1.91 at the last follow-up. The differences among different follow-up times were of statistical significance. The Hip flexion and extension, adduction and abduction, and internal and external rotation improved from 86.67°±16.70°, 34.06°±7.05°, 34.53°±7.45° preoperatively to 141.73°±6.56°, 57.06°±3.83°, 75.18°±4.00° at the last follow-up, respectively. At 3 months after the operation, the X-ray showed satisfied bone integration. There were no acetabular and femoral shaft fractures, sciatic nerve, femoral artery and vein injuries during the operation, and no joint dislocation, prosthesis loosening, infection and deep venous thrombosis of lower limbs during the postoperative and follow-up duration. Conclusion The dual mobility total hip prosthesis has the advantages in good initial and middle stability, rapid bone growth, low dislocation rate and repid recovery of postoperative motion range. It is suitable for patients over 65 years old or younger patients with postoperatively high dislocation.

Objective:To investigate the characteristics of blood glucose fluctuation and risk factors in type 2 diabetic patients with asymptomatic hypoglycemia.Methods:From September 2018 to July 2021, 342 patients with type 2 diabete mellitus who were hospitalized in the Department of Endocrinology of Hefei Hospital Affilitated to Anhui Medical University were enrolled for a retrospective study. The mean amplitude of glycemic excursions(MAGE), coefficient of variation (CV), 24 hour mean blood glucose level (MG), and time in range (TIR) were obtained by continuous glucose monitoring (CGM). According to the results of CGM and whether the patients have hypoglycemia symptoms, they were divided into three groups: no hypoglycemia group, symptomatic hypoglycemia group, and asymptomatic hypoglycemia group. The differences in blood glucose fluctuations were compared among the three groups. Multivariate logistic regression analysis was used to evaluate the risk factors in type 2 diabete mellitus patients with asymptomatic hypoglycemia. The predictive value of MAGE for asymptomatic hypoglycemia was analyzed by receiver operating characteristic (ROC) curve.Results:Compared with the non-hypoglycemia group, the TIR in asymptomatic hypoglycemia group was higher ( Z=-2.042, P=0.041). The asymptomatic hypoglycemia group had lower MG, higher MAGE and CV compared with the other two groups(all P<0.05). Multivariate logistic regression analysis showed that urinary albumin/creatinine ratio (UACR), MAGE, and CV were the risk factors for asymptomatic hypoglycemia, while MG was the protective factor. After adjustment for other risk factors, MAGE was still associated with asymptomatic hypoglycemia ( OR=1.111, 95% CI 0.999-1.235, P=0.049). The sensitivity and specificity of MAGE in predicting asymptomatic hypoglycemia were 0.769 and 0.776, respectively. Conclusions:Patients with asymptomatic hypoglycemia present with larger TIR and MAGE. MAGE, UACR, and CV were risk factors for asymptomatic hypoglycemia. Moreover, MAGE has some predictive value for the occurrence of asymptomatic hypoglycemia.

BACKGROUND: The patients with advanced lung adenocarcinoma should select targeted drugs based on the type of tumor epidermal growth factor receptor (EGFR) gene mutation. However, it is difficult to collect tumor tissue of advanced lung adenocarcinoma, and some experts agree that peripheral blood can be used as a substitute for tumor tissue as a test specimen. This paper aimed to investigate the clinical value of ddPCR and super-amplification refractory mutation system (ARMS) in detecting EGFR gene mutation in peripheral blood of patients with advanced lung adenocarcinoma. METHODS: A total of 119 patients diagnosed in Beijing Chest Hospital Affiliated to Capital Medical University from February 2016 to February 2019 were collected, and the sensitivity and specificity of plasma ctDNA EGFR gene mutation detected by ddPCR and super-arms were compared. Some patients with positive EGFR gene mutations received oral treatment with first-line EGFR tyrosine kinase inhibitors (EGFR-TKI). The patients were divided into subgroups according to the test results. In group 1, both ddPCR and super-arms showed positive EGFR gene mutation results, with 21 cases. In group 2, ddPCR and super-arms detection of EGFR gene mutation were all negative, with 16 cases. In group 3, the ddPCR test was positive and the super-arms test was negative, with 5 cases. In group 4, the ddPCR test result was negative while the super-arms test result was positive. Since the number of patients in group 4 was 0, no statistics were included. Objective response rate (ORR) and disease control rate (DCR) were used to evaluate the short-term outcome, and progression-free survival (PFS) was compared with survival analysis to evaluate the long-term outcome. RESULTS: EGFR mutations were detected in 58 (48.7%) of 119 patients with advanced lung adenocarcinoma. The coincidence rate between ddPCR and EGFR gene mutation in tumor tissues was 82.4% (Kappa=0.647, P<0.001), the sensitivity was 74.1%, and the specificity was 90.2%. However, the coincidence degree of super-arms test and tissue test was 71.4%, the sensitivity was only 58.6%, and the specificity was 83.6%. The ORR and DCR values in group 3 were lower than those in group 1 and 2, but there was no significant difference in ORR between groups (P>0.05). Survival analysis showed that the PFS of the three groups was compared. The difference was not statistically significant (χ²=2.221, P=0.329). CONCLUSIONS ddPCR, as a high sensitivity and specificity liquid gene detection method, can be used as a reliable method to detect the mutation of plasma ctDNA EGFR gene in patients with advanced lung adenocarcinoma. The results of plasma genetic testing can also be used as the basis for predicting the efficacy of EGFR-TKIs in patients.