Objective Nonparametric maximum likelihood estimate(NPMLE)and Breslow-Fleming-Harrington estimate(BFH)are extremely sensitive to small risk set for left truncated and right censored data,this study aims to develop estimation methods to improve the estimation accuracy and compare the existing methods.Methods We introduced the NPMLE,weighted NPMLE,conditional NPMLE,BFH and a new weighted BFH estimate.Simulation studies were carried out to compare five methods via the integrated absolute error(IAE) and integrated average width(IAW).Results The IAE of NPMLE,BFH,weighted NPMLE,weighted BFH and conditional NPMLE is ascending in turn;The IAW of weighted BFH is the lowest and NPMLE is the largest,BFH,conditional NPMLE and weighted NPMLE is reversed under different censored rate.Conclusion According to the results of simulation and example,weighted BFH and weighted NPMLE is recommended in turn when the risk set is small.Otherwise,the results of five methods would be consistent.

Objective To report our experience on construction of detenial sigmoid neobladder after laparoscopic radical cystectomy in 71 cases.Methods From August 2002 to May 2006,a total of 71 patients with invasive bladder carcinoma underwent construction of detenial sigmoid neobladder after laparoscopic radical cystectomy in our hospital.After the bladder was excised by laparoscopy,a 5-to 7-cm incision was made on the abdomen to remove the resected tissues,and then a 15-to 20-cm sigmoid colon was resected,the two colic bands opposite to the mesentery and the circular muscle and seromuscular layers between them were removed to construct a detenial sigmoid neobladder.Afterwards,the neobladder was anastomosed with the posterior urethra.Laparoscopic anastomosis was performed in 26 of the cases.Results The operation time was 240-390 min totally in the 71 cases.Laparoscopic radical cystectomy was finished in 80-270 min(mean,180 min),and the open surgery was completed in 160-240 min(mean 140 min).Oral intake was started at day 4-8 postoperation,ureteral stents were removed at week 3-4,and urethral catheter was removed at week 4.Three months after the operation,the mean intra-bladder pressure was 22.0 cm H2O(17-38 cm H2O),average bladder reservoir was 340 ml(200-410 ml),volume of residual urine was less than 25 ml in all the cases(

Objective To explore the effect and complication of diode laser and long-pulsed alexandrite laser for hair removal in different skin type.Methods A total of 1061 patients (1741 sites) were divided into 2 groups by skin type:one group were treated with diode laser,with wave length of 810 nm,and pulse width of 400 ms,with 12 mm × 10 mm spot size; another group were treated with long-pulsed alexandrite laser,with wave length of 755 nm,of pulse width of 20 ms,with 12.5 mm spot size,50-60 days intermitted between each treatment.Results The effect of hair removal by two lasers in different skin type was without divergence,but to darker skin,complication was lower when treated by diode laser.Conclusions The effect of hair removal by two lasers in different skin type is similar,but diode laser on hair removal is much safer to dark skin.

[Summary] In newly diagnosed diabetic patients, fasting plasma glucose, HbA1C , and plasma lipid profiles were measured to analyze the association between HbA1C and plasma lipid profiles. HbA1C might affect plasma lipid profiles in newly diagnosed diabetic patients. Higher HbA1C was associated with the worse plasma lipid profiles and more severe insulin resistance.

Objective To investigate and analyze oral health status of inpatients with schizophrenia.Method We selected 105 patients from Beijing Anding hospital included hospitalization length 1-5 years group (39 cases) and hospitalization length over 5 years (55 cases) were investigated with Self-made questionnaire and assessment guide for psychiatric care (OAG-PC).Results Tooth loss and oral health status of schizophrenia inpatients were both poor.There was significant difference in the number of people with tooth loss (x2 =7.68,P ＜ 0.05) and mean number of tooth loss (F =9.20,P ＜ 0.05) between two groups.The OAG-PC total score (F=11.1,P＜ 0.05),odour from the mouth (F=4.34,P＜ 0.05),saliva (F=3.93,P＜ 0.05),mucous membranes (F=5.64,P＜ 0.05),teeth or dentures (F=5.34,P＜ 0.05),calculus on teeth (F=15.34,P ＜ 0.05),looseness of teeth (F =14.14,P ＜ 0.05),and No.of teeth in the lower jaw (F =7.70,P ＜ 0.05) in the schizophrenia inpatients with hospitalization length 1-5 years group was better than those with hospitalization length over 5 years,there were significant difference between two groups.There were no significant difference in lips (F =0.69,P ＞ 0.05),tongue (F =0.65,P ＞ 0.05),gums (F =1.87,P ＞ 0.05),appearance of teeth (F=1.52,P＞ 0.05),and No.of teeth in the upper jaw (F=3.58,P ＞ 0.05) between two groups.Conclusions Patients with schizophrenia are special vulnerable people.The more course of the disease was longer,the more the oral health status was worse.Tooth loss,calculus,and looseness of teeth are much more serious and will influence chew function seriously.Society,medical institutions,and families should pay more attention to the oral health status of patients with schizophrenia.And taking the preventative measures against poor oral health can improve quality of life of patients with schizophrenia.

Objective The aim of the present study is to evaluate the reliability and validity of the Mandarin version of the PP (MPP) .Methods The first step in the establishment was to translate the original English version into mandarin version with the method of cross -culture translation .The reliability was performed with the internal consistency analysis and test -retest reliability .The validity was performed for the content validity and structure va-lidity .The samples were from 80 Chinese CI children ,and 43 parents answered this questionnaire again 1 month lat-er to evaluate the test -retest reliability .The average age at cochlear implantation were 26 ± 14 months ,ranging from 7 months to 68 months ,the average duration of CI use were 10 ± 7 months ,ranging from 0 month to 24 months .Results The reliability analysis indicates that the Cronbach'sαcoefficient was 0 .797 ,except for the well-being and happiness ,education ,whose coefficients are respectively 0 .303 ,and 0 .341 ,all of the other sundomainscoefficient were greater than 0 .5 ,indicating the internal consistency was good .Test -retest reliability of the scale Cronbach'sαwas satisfactory .All subdomains and total score of the scale coefficients were greater than 0 .70(P<0 .01) .The validity analysis indicated that the pearson correlation coefficients among the total scale and the 8 subdo-mains were 0 .395~0 .992 ,the correlation coefficients among each subdomains were 0 .09~0 .654 ,which confirmed with the psychological characteristics ,proving its good structure validity .Conclusion The Chinese version of the PP show s good reliability and validity and can be used to evaluation the quality of life in mandarin CI children.

Objective To present our initial experience of pure laparoendoscopic single-site surgery (LESS) for radical cystectomy and bilateral pelvic lymph node dissections. Methods 10 patients with pathology confined bladder urothelial carcinoma underwent laparoendoscopic single-site radical cystectomy, including 9 males and 1 female. After a 3-4 cm lower median abdominal incision was made, quadport or homemade single multichannel port was inserted, and conventional and prebent laparoscopic instruments were utilized. The surgical procedure included bilateral pelvic lymphadenectomies, radical cystectomy and building with a sigmoid orthotopic neobladder by open surgery.Results No extra port needed, neither conversion to open or conventional laparoscopic surgery. The time of LESS procedure ranged from 130 to 330 min (mean 243 nin). Estimated blood loss ranged from 50 to 600 ml (mean 270 ml). 5 patients needed blood transfusion of 2 to 4 units. The pathologic evaluation revealed bladder urothelial carcinoma, negative margins and negative pelvic lymph node involvement. No mortality or severe complications were observed perioperatively. After followup of more than 6 months, all revealed controllable urination at daytime, while 4 revealed nocturnal incontinence and needed one or two pads during nighttime. No evidence of recurrent or metastatic disease was detected. Conclusions LESS radical cystectomy and bilateral lymphadenectomies was safe and feasible, and short-term follow-up showed good tumor control outcomes. Homemade single multichannel port made of two elastic ring and glove was simple and effective.

Objective To constructe ,package and identificate the lentiviral vector with overexpression gene Grp78 .Methods We used lentiviral vector and genetic engineering technology to obtain the aim gene fragment and to constructe recombinant plas‐mid .we prepared competent cells and transform the cells .Through positive clone sequencing ,lentivirus was packaged and virus titer was tested .Results Positive cloning sequence comparison results show that the test was passed .Melt curve did not appear mixed peak ,also did not appear abnormal peak broadening .It means that does not appear pollution ,primer dimers and nonspecific amplifi‐cation in the experiments .Conclusion The construction ,packaging and identification of lentiviral vector with over expression gene Grp78 are sucessful .

Malignant pheochromocytomas are rare tumors that arise from chromaffin tissue, and the diagnostic criterion of malig-nancy is based on the development of metastases. In the case a patient suffers the tumor with liver, lung and bone metastases. However, the test results of tumor markers, gastroscopy, chest and abdominal CT, and PET-CT examination are hard to make a definite diagnosis. The patient was finally diagnosed with malignant pheochromocytoma with liver, lung and bone metastases following the needle biopsy of liver and underwent the excision of a right adrenal pheochromocytoma. Therapeutic standard for the malignant pheochromocytomas is not available so far. It is reported that chemotherapeutic CVD regimen (cyclophosphamide, vincristine, and daecarbazine) and suni-tinib may be effectual in the alike cases. The patient received two cycles of CVD and one cycle of sunitinib, nevertheless, slow progres-sion of the disease remained after the treatment. The results of multi-disciplinary treatment have suggested that 131I-MIBG may just be a choice for this patient.

Objective To observe the clinical efficacy and safety of apatinib in the treatment of advanced malignant tumors and to analyze the prognostic indicators affecting the survival of patients.Methods A total of 100 patients with advanced malignant tumors who were treated with apatinib at Jinan Central Hospital Affiliated to Shandong University from February 2015 to July 2018 were enrolled and their data were analyzed retrospectively.The clinical efficacy was evaluated and the related adverse reactions were recorded.Single and multiple factor analyses were pefformed by Cox regression model.The predictive factors of progression-free survival (PFS) and overall survival (OS) were analyzed.Results One-hundred patients with advanced malignant tumors who were treated with second-line and above treatment were collected.All patients were assessable for response,no complete response was observed,22 patients (22％) achieved partial remission,58 patients (58％) in stable disease,and 20 patients (20％) appeared progressive disease.The objective response rate was 22％ (22/100),the disease control rate was 80％ (80/100),the median PFS was 3.6 months (95％ CI:2.7-4.5 months),and the median OS was 7.0 months (95％ CI:4.7-9.3 months).Univariate analysis showed that Eastern Cooperative Oncology Group (ECOG) score (HR =0.340,95％ CI:0.211-0.546,P ＜0.001),tumor primary site (HR =1.757,95％ CI:1.053-2.932,P =0.031),neutrophil to lymphocyte ratio (NLR) (HR =0.389,95％ CI:0.227-0.666,P =0.001),hemoglobin (HR =1.696,95％ CI:1.023-2.813,P =0.041) and proteinuria (HR =1.790,95％ CI:1.105-3.155,P =0.044) were related to PFS;age (HR =2.082,95 ％ CI:1.320-3.285,P =0.002),ECOG score (HR =0.206,95％ CI:0.123-0.344,P＜0.001),tumor primary site (HR=1.784,95％CI:1.077-2.954,P=0.025),NLR (HR=0.410,95％CI:0.238-0.704,P =0.001),hemoglobin (HR =1.958,95％ CI:1.175-3.264,P =0.010) and albumin (HR =0.467,95％ CI:0.277-0.787,P =0.004) were related with OS.Multivariate analysis showed that PFS was related to ECOG score (HR =0.254,95％ CI:0.123-0.523,P ＜ 0.001) and NLR (HR =0.378,95％CI:0.161-0.888,P =0.026),and OS was related to ECOG score (HR =0.147,95％ CI:0.067-0.326,P ＜0.001),NLR (HR =0.327,95％ CI:0.140-0.765,P =0.010) and hemoglobin (HR =1.975,95％ CI:1.101-3.543,P =0.022).In term of safety,the most common adverse events among 100 cases of treated patients with advanced malignant tumors were hypertension (53,53 ％),anorexia (51,51％),fatigue (51,51％) and anemia (50,50％),among which the most common ones of grade 3 and 4 were hypertension (10,10％),thrombocytopenia (8,8％),leukopenia (7,7％) and hand-foot syndrome (6,6％).Conclusion Apatinib has certain clinical efficacy and manageable adverse events in the treatment of advanced malignant tumors at and above second-line treatment.ECOG score and NLR are independent predictors of PFS and OS in patients with advanced malignant tumors treated with apatinib.