Objective To investigate the effect of dexmedetomidine on perioperative cell immune function in patients undergoing hepatoma surgery. Methods Sixty patients (40-65 y/o, 50-80 kg body weight, ASA grad-ing I-II) with hepatoma were allocated into two groups each containing 30 patients:control group (group C) and dex-medetomidine group (group D). 15 minutes before anesthesia induction, a loading dose of dexmedetomidine 0.5μg/kg was injected intravenously, followed by infusion at 0.4μg/(kg · h)until the end of operation in group D. The equal volume of normal saline was administered in group C.Blood samples were obtained from jugular vein before induc-tion of anesthesia (T0), the end of operation(T1) and 24 h after the end of surgery (T2) for detections of the levels of T lymphocyte subsets (CD3+, CD4+, CD8+) and NK cells by flow cytometry. CIM+/CD8+ratio was calculated. Serum IL-2 and IL-10 were detected by ELISA methods. Results When compared with the baseline value (T0), the levels of CD3+, CD4+, CD4+/CD8+ratio and NK cells significantly decreased at T1 and T2 in group C, and the levels of CD3+and CD4+also significantly decreased at T1 and T2 in group D (P<0.05). Compared with group C, the levels of CD3+, CD4+, NK cells and IL-2 at T1 and T2 were significantly higher in group D, and level of IL-10 at T1 and T2 were significantly lower in group D (P < 0.05). Conclusion Dexmedetomidine could improve the postoperative suppression of immune function in patients undergoing hepatoma surgery.

Objective:To study the clinical features and prognostic factors of brain injury after radiothera-py for nasopharyngeal carcinoma(NPC).Methods:From January 1998 to June 2006,49 NPC patients with Dost-radiation brain injury in our hospital were analyzed retrospectively.Results:The incidence of post-radia-tion brain injury after single-pass radiotherapy and re-course radiotherapy was 2.31%and 9.64%.respectively ,(P＜0.05).The median latency period was 50.5 months for single-pass radiotherapy and 25.5 months for re-course radiotherapy.Fourty-nine patients suffered from radiation injury in the brain.The lesions were locat-ed in the temporal lobe in 37 patients(75.5%),in the pens in 9 patients(18.4%)and in mixed position in 3 pa-tients(6.1%).The symptoms and signs of the patients could be alleviated by therapy, but the quality of life was not improved.Conclusion:Radiation brain injury in NPC patients after radiotherapy is related to field de-sign.The incidence of radiation brain injury in the temporal lobe is the highest.Compared with single-pass ra-diotherapy, re-course radiotherapy leads to higher incidence of brain injury and shorter latency period.

目的探讨截肢后残疾人综合康复策略。方法个案分析。9岁女童,因车祸骨盆以下截肢。各学科专家和社会工作者组成康复团队,进行综合康复。结果4个月后,女童装上假肢,恢复清纯女孩的外观形象,学会使用假肢、轮椅或特制的小滑板代步,日常生活能力(ADL)提高,正常上学,成绩优秀;将来准备向残疾运动员方向发展。结论综合康复可以实现残疾人回归社会。

Objective To investigate the correlation between the rate of pathological complete response (pCR) and prognostic nutritional index (PNI) in gastric cancer patients who underwent neoadjuvant chemotherapy (NAC). Methods A total of 278 advanced gastric cancer patients who underwent NAC and R0 gastrectomy with D2 lymphadenectomy between January 2012 and March 2017 at the Affiliated Tumor Hospital of Zhengzhou University were analyzed retrospectively. Propensity score matching (PSM) was conducted to reduce the confounding bias between the groups (PNI＜45, 157 patients; PNI≥45, 121 patients). Multivariate analysis was used to determine the independent risk factors of the pCR rate in gastric cancer patients who underwent NAC. Results PNI (OR:3.026;95％ CI:1.261, 7.260;P = 0.013), differentiation (OR:0.470;95％ CI:0.270, 0.819;P = 0.008), and tumor location (OR:0.341;95％ CI:0.164, 0.708;P = 0.004) were the independent risk factors associated with the pCR rate of the gastric cancer patients who underwent NAC. After PSM, PNI (OR:2.728;95％ CI:1.130, 6.587;P = 0.026) was the independent risk factor associated with the rate of pCR after NAC. Conclusion Gastric cancer patients who underwent NAC with low PNI are less likely to get pCR than those with normal PNI.

OBJECTIVE：To interpret the key points in local standard Specification for Pharmacy Intravenous Centralized Admixture（DB11/T 1701-2019）（Beijing Local Standard for short ）in Beijing ，and to provide guidance and reference for managers of medical institutions and staff of PIVAS to deeply understand the standard and further improve the quality of PIVAS in medical institutions. METHODS ：The background and main content of Beijing Local Standard were interpreted in detail ，and then compared with Quality Specification of Pharmacy Intravenous Admixture （National Specification for short ）promulgated by Chinese National Ministry of Public Health and Quality Specification of Pharmacy Intravenous Admixture Services of Guangdong Provincial （Trial）（Specification of Guangdong Province for short ）promulgated by Guangdong Pharmaceutical Association. RESULTS & CONCLUSIONS：Beijing Local Standard had been promulgated and implemented by Beijing Municipal Administration for Market Regulation on April 1st，2020. The text of Beijing Local Standard is divided into 7 parts，mainly including the scope of application，normative references ，terms and definitions ，basic requirement ，environmental requirements （design，location， layout），equipment and facilities （ventilation system and console ，operation and maintenance ），and admixture requirements. Beijing Local Standard further refines the relevant contents on the basis of following the requirements of National Specification . Like Specification of Guangdong Province ，the applicability and operability of the standard are enhanced by combining their local characteristics and practice status. As the first local standard in this domain ，the local standard is expected to promote the improvement of the working quality of PIVAS in Beijing ，enable the PIVAS of proposed construction ，under construction and operation maintenance to meet uniform standards and reduce the failure of acceptance or reconstruction after completion.

OBJECTIVE: To investigate the prognostic value of tumor deposits(TD)in N0 stage gastric cancer. METHODS: A retrospective case-control study was performed on clinicopathological data of 751 N0 stage gastric cancer patients who underwent subsequent R0 gastrectomy from January 2011 to February 2013 at Zhengzhou University Affiliated Tumor Hospital. Patients were divided into TD-negative group (688 cases) and TD-positive group (63 cases). Propensity score matching was used to balance the covariances between the two groups, such as age, gender, differentiation degree, tumor location, T stage, perineural invasion, lymphovascular invasion, extent of resection, tumor size, surgical procedure,and chemotherapy. Matching was performed by the minimal adjacent method of 1:2 pairing. The survival analysis was carried out using Kaplan-Meier method,and differences between the curves were detected by log-rank test. Cox proportional hazard model was used to perform univariate analysis and multivariate analysis. RESULTS: After matching,56 patients were allocated into the TD-positive group and 112 patients into the TD-negative group, and the baseline of clinicopathological data of 2 groups matched well (all P>0.05). The median follow-up time was 55.2 (12.0-83.2) months, and 3 patients were lost to follow-up (died of other diseases). In TD-positive group, 38 patients died of gastric cancer and 1 died of other disease. In TD-negative group, 52 patients died of gastric cancer and 2 died of other diseases. The TD-positive group had lower 5-year survival rate than TD-negative group (31.0% vs. 52.9%,χ²=6.230, P=0.014). Subgroup analysis showed that the 5-year survival rate of T1-2 stage TD-positive patients was significantly lower than that of T1-2 stage TD-negative patients (47.1% vs. 92.6%, χ²=11.433,P<0.001),while the difference between two groups with T3-4 stage (23.8% vs. 40.0%, χ²=2.995,P=0.084)was not significant. In patients receiving chemotherapy, the 5-year survival rate of TD-positive group was significantly lower than that of TD-negative group(34.1% vs. 54.8%, χ²=4.122, P=0.042). Further subgroup analysis showed that patients receiving postoperative chemotherapy of TD-positive group both in T1-2 stage (63.6% vs. 100%, χ²=3.830,P=0.048) and in T3-4 stage (24.2% vs. 48.4%, χ²=4.740,P=0.029) had significantly lower 5-year survival rates than those of TD-negative group. However,T1-2 stage TD-positive patients receiving chemotherapy had significantly higher 5-year survival rate as compared to those without receiving chemotherapy(63.6% vs. 16.7%, χ²=5.474,P=0.019).Univariate analysis revealed T stage (HR=1.829, 95%CI:1.490-2.245, P<0.001),perineural invasion (HR=2.620, 95%CI:1.617-4.246,P<0.001),tumor size (HR=1.646, 95%CI:1.078-2.512, P=0.021),TD(HR=1.691,95%CI:1.112-2.572,P=0.014) were associated with the prognosis of patients with gastric cancer. Multivariate analysis showed TD-positive (HR=2.035, 95%CI:1.325-3.126, P=0.001), later T stage (HR=1.812, 95%CI: 1.419-2.313,P<0.001), perineural invasion (HR=1.782,95%CI:1.058-3.002,P=0.030) were independent risk factors for the prognosis of gastric cancer. CONCLUSIONS TD is an independent risk factor for N0 stage gastric cancer,and may be closely related to T stage. Patients with TD-positive stage T1-2 should receive chemotherapy, but the prognosis of TD-positive patients undergoing adjuvant chemotherapy is poorer as compared to TD-negative patients. Therefore, more individualized treatments should be administrated.
Antineoplastic Agents ; therapeutic use ; Case-Control Studies ; Chemotherapy, Adjuvant ; Gastrectomy ; Humans ; Neoplasm Staging ; Prognosis ; Propensity Score ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; mortality ; pathology ; surgery ; Survival Analysis ; Survival Rate

Food enzymology and enzyme engineering is an important professional course of food science. The course includes the basic theory of enzymology, enzyme engineering technology and the application of enzymes in food industry. Considering the knowledge gap between the teaching contents and the cutting-edge researches, the team constantly adjusted and optimized the course contents to enable students to keep up with state-of-the-art progress by carefully mining the cutting-edge researches. Taking cutting-edge researches as the breakthrough point, we explored the problem-based learning (PBL) teaching model under the guidance of outcome-based education (OBE) concept, and highlighted the importance of the teacher-student and student-student interactions to improve students' enthusiasm and participation. A diversified assessment system was established to evaluate the performance of students in the learning process. The teaching reform consolidated the basic knowledge and expanded the academic frontiers, and fostered students' ability in analyzing problems, designing solutions and achieving team communication. The course may give new insights into the teaching reform of food enzymology and enzyme engineering and other related courses.
Humans ; Students ; Learning