Objective To evaluate surgical therapy for recurrent rectovaginal fistula.Methods In this study.two patients were treated by endorectal advancement flap repair and one patient was treated by vascular pedicled segment of small bowel.Results All patients were cured and followed up from 4 to 20 months.During the period of follow-up there was no recurrence.Conclusions The procedures and timing of operation are important factors for a successful repair.Both the endorectal advancement flap and patch of intestine provide an effective methods in repairing recurrent rectovaginal fistula.

Objective To study clinical feature and therapeutic choice of pituitary adenomas. Methods The clinical data of 239 cases of pituitary adenomas were analyzed. Results Total 93 male and 146 female cases were recruited. The average age was (43.8 ± 14.9 ) years old (3.9-77 years). Prolactinomas were the most common pituitary adenomas (26.8%) , 179 patients (74.9%) underwent surgery, of which 108 (60.3%) with transsphenoidal approach and 71 (39.7%) transcranial approach. The other 60 cases were treated nonsurgically. Conclusions Pituitary adenomas may present hormonal abnormalities or neurological symptoms.Some adenomas were accidently detected by MRI. Prolactinomas were the most common pituitary adenomas.

Objective To investigate the effects of Dihuang Yinzi (DY) on the receptor for advanced glycation end-products(RAGE)/reactive oxygen species(ROS)/apoptosis pathway in SH-SY5Y cells induced by amyloid-beta1-42 (Aβ1-42) oligomer. Methods Firstly, we adopted methyl thiazolyl tetrazolium(MTT) method to detect the cell vitality in fetal bovine serum (FBS) group, blank serum group, and low-, middle- and high- dose DY-containing serum groups, so as to confirm the optimal concentration and treatment time of DY-containing serum. Secondly, we applied MTT method to detect cell vitality and applied Annexin V/propidium iodide (PI) staining method to observe the apoptosis of SH-SY5Y cells treated with 0~20 μmol/L Aβ1-42 for 24 and 48 h, so as toconfirm the optimal concentration and treatment time of Aβ1-42 for establishing Alzheimer's disease (AD) model in vitro. Thirdly, MTT method was used for the detection of cell vitality, and Annexin V/PI staining method was used for detection of the apoptosis of SH-SY5Y cells in blank serum group, model group, western medicine control group and low-, middle-and high-dose DY-containing serum groups, and Dihydroethidium (DHE) method was used for the assay of ROS contents, so as to observe the effect of DY on the recovery of injured SH-SY5Y cells induced by Aβ1-42. Finally, we applied Western blot method to detect the expression level of RAGE in SH-SY5Y cells of blank group, model group and DY-containing serum group; after Aβ1-42-induced SH-SY5Y cells were transfected with RAGE gene, we adopted DHE staining method and Annexin V/PI staining method to detect ROS content and cell apoptotic rate in all of the above groups, so as to observe the effect of DY on SH-SY5Y cell apoptosis and RAGE expression. Results The cell vitalities were increased in low- and middle-dose DY-containing serum groups at 24 h (P < 0.05 or P < 0.01 compared with that in the blank serum group). The conditions for the establishment of AD model in vitro were as follows: the optimal concentration of Aβ1-42 was 5μmol/L, and the treatment time was 24 h. The cell vitalities were significantly enhanced, the cell apoptotic rate and ROS content were significantly lowered in Aβ1-42-induced SH-SY5Y cells of the medication groups(P <0.05 or P < 0.01 compared with those in the model group) , and the cell vitality was the highest and the cell apoptotic rate was the lowest in the middle-dose DY-containing serum group. The RAGE expression level was decreased in Aβ1-42-induced SH-SY5Y cells of the middle-dose DY-containing serum group(P < 0.05 compared with that in the model group) . ROS content and cell apoptotic rate were decreased in Aβ1-42-induced SH-SY5Y cells transfected with RAGE gene in the middle-dose DY-containing serum group (P<0.01). Conclusion DY may play an anti-oxidative role through inhibiting the production of ROS and cell apoptosis, thus to suppress RAGE protein and to achieve the preventive and therapeutic effect for AD.

Objective A phase Ⅱ trial of anti-programmed death-1 (PD-1) monoclonal antibody CT-011,an anti PD-1 humanized monoclonal antibody combined with rituximab therapy in patients with relapsed follicular lymphoma (FL) were conducted.Methods In order to evaluate the safety and efficacy of CT-011,the impacts of CT-011 on immune cells both from the peripheral blood (PB) samples and tumor microenvironment were examined.PB and core needle biopsies from involved lymph nodes were collected prior to and on day 14 after the first infusion of CT-011.PB mononuclear cells (PBMC) were analyzed by multiparametric flow cytometry to determine various immune cell subsets.Whole genome gene expression profiling (GEP) was performed on core needle biopsies.Results A significant increase in the absolute number of PB immune cells were observed in day 14 samples compared with baseline including total lymphocyte count (P ＜ 0.01),CD+3 T cells (P =0.01),CD+4 T cells (P ＜ 0.01).Comparison of GEP from core needle biopsies obtained pretreatment and day 14 (n =8 pairs) showed up regulation of several genes associated with T cell activation.Conclusion Administration of CT-011 was associated with increase in the numbers of CD+4 T cells and resulted in activation of T cells in the PB and the tumor microenvironment in FL.These results provide insight into the mechanism of action of CT-011 and offer a predictive biomarker for selection of patients for future clinical trials with this class of agents in FL.

Objective:To find out the prevalence and risk factors of Atopic Dermatitis(AD) of children under 1 year old in Shihua area ,Jinshan District ,Shanghal .Methods:Neonatal general conditions at birth were collected in Jinshan Hospital , Fudan University from September 2012 to August 2013 ,while questionnalre survey was conducted to understand the correlative factors .Follow‐up was done at 1 ,2 ,6 ,9 ,12 month‐old so as to understand the incidence of AD and the conditions about feeding and growth .Results:There were 2426 newborns were selected ,and 915 were followed‐up .There were 271 AD patients ,and the prevalence rate is 29 .6% .Prevalence rate of AD was 29 .9%‐37 .6% in newborns who were born in March , April ,May ,July ,August and September ,which was higher than those in other months(20 .7%‐24 .2% ) .Univariate analysis showed that the prevalence of AD was significantly correlated with parents’ allergies and increase of the eosinophil count in infant blood (P<0 .01) .It was also correlated with boy ,caesarean section ,artificial feeding or mixed feeding ,mother’s high level of education of mothers ,passive smoking ,and there were significant differences (P< 0 .05) .However ,it was not correlated with the mother’s prenatal history of infection (P>0 .05) .Multivariate logistic regression analysis showed that AD prevalence rate was significantly correlated to mother’s high level of education ,increase of eosinophil count in infant blood(P<0 .01) .It was also correlated to caesarean section ,artificial feeding or mixed feeding ,parental allergy history ,and there were significant differences(P< 0 .05) .Conclusions:The prevalence rate of infant AD in Jinshan District of Shanghal City was 29 .6% .The incidence of AD had seasonal trends .Infants ,who were born in the spring and summer ,had higher prevalence rates of AD .Parents with allergies ,mother’s high level of education ,artificial feeding or mixed feeding after birth ,caesarean section and increase of eosinophil count in infant blood are risk factors for infant AD .

Objective To evaluate the effects of multi-functional self-help lower extremity training band on elderly patients after hip fracture surgery. Methods A total of 120 elderly patients after hip fracture surgery were randomly divided into two groups experimental group (n=60) and control group (n=60). The patients of two groups were treated with routine care, but patients of experimental group also received functional exercise using multi-functional self-help lower extremity training. The compliance of functional exercise were compared between two groups, and the effects of postoperative rehabilitation exercise were evaluated. Results The exercise effects of knee joint and hip joint in experimental group were significantly better than those in control group (χ2 =14. 90,13. 89;P<0. 05). The patients′compliance of functional exercise in the experimental group was significantly higher than that in the control group (P<0. 01). Conclusions The using of multi-functional self-help lower extremity training band can improve the compliance of functional exercise and the effects of rehabilitation on elderly patients after hip fracture surgery, and can promote the progress of rehabilitation.

Objective:To construct transitional care evaluation system for lung cancer patients with chemotherapy based on Omaha systemtheory.Methods:Based on literature research, the first draft of transitional care evaluation system for lung cancer patients with chemotherapy was preliminarily formulated by combining Omaha system, content analysis, cross-mapping method and expert group meeting. By using Delphi expert consultation method, 15 experts from the field of oncology medicine and oncology nursing were conducted two rounds of expert consultation from January 2019 to March 2019. Finally, the transitional care evaluation system for lung cancer patients with chemotherapy was formed. From April 2019 to May 2019, 30 lung cancer patients with chemotherapy in a cancer specialist hospital were selected to evaluate the importance of the contents of the transitional care nursing evaluation system. The enthusiasm of experts was expressed by the effective recovery rate of the questionnaire, the authority of experts was expressed by the expert authority coefficient ( Cr) , the coordination degree of expert opinions was expressed by the coefficient of variation and Kendall coordination coefficient, and the concentration degree of opinions was expressed by the value of importance. Results:The recovery rates of the two rounds of expert consultation questionnaires were 100%. The expert authority coefficient of the second round of expert consultation was 0.80. Kendall's coordination coefficients of the first-levelindicators and second indicators were 0.300 and 0.160 respectively ( P<0.001) . The evaluation opinions of experts and patients tended to be consistent. The transitional care evaluation system for lung cancer patients with chemotherapy was finally constructed, including 8 first-level indicators and 62 second-level indicators. Conclusions:In this study, contents of transitional care evaluation system for lung cancer patients with chemotherapy are scientific and reasonable, which can provide a reference for the effective implementation of transitional care for lung cancer patients with chemotherapy.

Objective To investigate the risk factors for postoperative prolonged mechanical ventilation in neonates and young infants with complicated congenital heart disease. Methods A retrospective analysis of 150 children (80 males and 70 females, aged ≤ 6 months, RACHS-1 grade ≥ 3) with complex congenital heart disease who were admitted to Children's Heart Surgery Department of Anzhen Hospital from January 2016 to December 2017 was conducted. These data were collected: the demographic data, history of cardicvascular-related diseases, type of surgery, preoperative complications, CPB, CPB time, deep hypothermia, blood gas index, delayed chest closure (DCC), pacemaker; minimum oxygenation index in the first 24 h after operation, maximum vasoactive-inotropic score (VIS), failed extubation and postoperative complications. Logistic regression model was used to analyze the risk factors of prolonged mechanical ventilation within neonates and young infants after complicated congenital heart surgery. Results Forty-two patients (28％) required PMV with mechanical ventilation ≥ 72 h. Univariate analysis showed age, weight, RACHS-1 grade, previous history of cyanosis, history of pneumonia, emergency surgery, preoperative mechanical ventilation, preoperative EF, deep hypothermia, CPB time＞ 132 min, intraoperative minmum pH value, intraoperative maximum blood glucose and lactic acid concentrations, DCC, application of pacemakers, maximum VIS within 24 h after surgery, minimal OI and postoperative complications may be the risk factors of prolonged postoperative mechanical ventilation in neonates and young infants with complicated congenital heart disease (P ＜ 0.05). Multivariate Logistic regression analysis showed that the CPB time＞132 min (OR = 11.04, 95％ CI 2.07-58.96, P = 0.005), intraoperative maximum lactate (OR = 1.53, 95％ CI 1.07-2.20, P = 0.021) and failed extubation (OR = 17.28, 95％ CI 2.46-121.20, P = 0.004) were independent risk factors for prolonged postoperative mechanical ventilation in neonates and young infauts with complicated congenital heart disease. Conclusion CPB time＞132 min, intraoperative maximum lactic acid concentration and failure of extubation can be used as predictors of prolonged postoperative mechanical ventilation in neonates and young infants with complicated congenital heart disease.

Fanconi anemia (FA) is an inheritable disorder that presents with bone marrow failure, developmental anomalies, and an increased susceptibility to cancer. The etiology of this condition stems from a genetic mutation that disrupts the proper repair of interstrand DNA cross-links (ICLs). The resultant dysregulation of the DNA damage response mechanism can induce genomic instability, thereby elevating the mutation rates and the likelihood of developing cancer. The FA pathway assumes a pivotal role in safeguarding genome stability through its involvement in the repair of DNA cross-links and the maintenance of overall genomic integrity. A mutation in the germ line of any of the genes responsible for encoding the FA protein results in the development of FA. The prevalence of aberrant FA gene expression in somatic cancer, coupled with the identification of a connection between FA pathway activation and resistance to chemotherapy, has solidified the correlation between the FA pathway and cancer. Consequently, targeted therapies that exploit FA pathway gene abnormalities are being progressively developed and implemented. This review critically examines the involvement of the FA protein in the repair of ICLs, the regulation of the FA signaling network, and its implications in cancer pathogenesis and prognosis. Additionally, it explores the potential utility of small-molecule inhibitors that target the FA pathway.