In order to assess the effect of long-term versus short-term intravesical chemotherapy in preventing the recurrence of patients with non-muscle-invasive bladder cancer, we searched several databases with words as mesh terms and free text words to find all eligible randomized clinical trials (RCTs) for the comparison of the two strategies of instillation durations. "Observed-Expected events research (O-E)" and "Variance (V)" for calculating hazard ratio (HR) were used in Revman 5.2 software recommended by Cochrane Collabration for data analysis. Sensitivity and subgroup analysis were selected to minish heterogeneity. GRADEpro 3.6 profile recommended by Cochrane Collabration was employed for quality assessment of analyses. Finally, 13 eligible RCTs with 4216 patients were included in this review and 16 comparisons from 13 trials were involved for analysis. The pooled analysis revealed no significant difference between long-term and short-term duration [HR=0.99, 95% CI (0.89, 1.11), P=0.89]. Within the subgroup analysis, patients benefited from long-term instillations with a start regimen of one immediate instillation [HR=0.83, 95% CI (0.69, 1.00), P=0.05]. But patients were not suitable to receive long-term instillations with epirubicin (EPI) [HR=1.01, 95% CI (0.91, 1.13), P=0.78]. The progression rate was not reduced after long-term instillations [HR=0.96, 95% CI (0.66, 1.39), P=0.82]. From our results, patients should not receive introvesical chemotherapy more than half a year. In contrast, patients with one immediate instillation are preferred to have a long-term duration at least one year. Long-term instillations can not reduce the progression rate.

Adult ; Humans ; Lipids ; blood ; Male ; Occupational Exposure ; Vanadium ; toxicity

Objective To investigate the score changes of graduates majoring in clinical medicine after using the method of “role of identification”. Methods Sixty students who were undertaking internship in Endocrinology Department of Shanghai Traditional Chinese Medicine Hospital received three-week clinical teaching and examination. Then they got into one-week “role of identification”, and were appointed as clinical teachers to teach what they have learned during the last 3 weeks to the next batch of interns and make another examination. Scores of the two examinations were compared. Results Scores of the examination after received the method in“role of identification”improved significantly (P<0.01). Conclusion The method of“role of identification”can enhance clinical medicine graduates’ mastery of professional knowledge.

Tricholoma giganteum is a famous species product of Jishou in the wes t of Hunan.It have not only special biological characteristics such as formatio n and ecological enviromment,but also delicious,fragrant with abundant nutrien t.It's mycelium can be isolated and growing well in medium,but its fruiting bo dy is difficult to be formed.

Objective:The purification process of thrombolysin was researched.Methods:Ultrafiltration,ionexchange chromatography,and hydrophobic-interation chromatography were used.Results:A single band of final purification product was displayed in PAGE (Coomassic Brilliant Blue Stain Method).Relative activity was 144.83.And recovery was 38.66%.Conclusion:The industrial feature was reflected in the purification process of thrombolysin.The purification process had practicability.

Objective To investigate the prevalence status and risk factors of mild cognitive impairment (MCI) in old people in pension facilities in Chongqing, China. Methods From October to November, 2015, the people above 60 years old in four pension facilities in Chongqing were cluster sampled. They were interviewed with Mini-Mental State Examination, Instrumental Activity of Daily Living Scale, self-made general situation questionnaire for the elderly and the Geriatric Depression Scale. Results There were 25 MCI patients identified in 84 old people selected, with the prevalence of 29.76%. MCI prevalence was different with the factors such as genders, educational levels, economical status, smoking, eating freshwater fish frequently, participating in outdoor activities frequently, playing Mahjong/chess/cards fre-quently, watching TV/listening to broadcast/reading newspaper frequently, participating in social activities frequently, having religious be-liefs, suffering high blood pressure (χ2>4.271, P<0.05). Based on multivariate Logistic regression analysis, male was the protective factor (OR=0.055, 95%CI:0.005~0.618), while high blood pressure was the risk factor (OR=8.281, 95%CI:1.278~53.646) to the MCI. Conclu-sion MCI is prevalent in old people in pension facilities in Chongqing, which needs intervention targeted to the risk foctors.

Objective To investigate the clinical effect of Ethibond suture and anchor fixation by arthroscopic technique for the treatment of avulsion fracture of the anterior cruciate ligament (ACL) tibial insertion.Methods Twenty patients with avulsion fracture of the ACL tibial insertion hospitalized between July 2013 and June 2014 were collected retrospectively.There were 12 males and 8 females,aged 18-41 years (mean,25.3 years).All patients were identified with type Ⅱ and type Ⅲ fractures according to the Meyers-McKeever classification.Results of Lachman test and anterior drawer test were both positive.All patients accepted the operation that avulsion fracture of the ACL tibial insertion was treated with the Ethibond suture and anchor fixation by arthroscopic technique within 3 weeks after injury.Follow-up X-ray examinations were carried out to evaluate the bone union.Lysholm and international knee documentation committee (IKDC) scores were used to evaluate the function of knee joint postoperatively.Results Operation time was 45-70 min (mean,50 min).Blood loss was 5-15 ml (mean,10 ml).Follow-up was conducted for 12-24 months (mean,16.3 months).Postoperative X-ray showed the reduction was satisfactory.Lachman test and anterior drawer test were both negative after operation.Knee functions were recovered to normal.Lysholm and IKDC scores were 89-96 points [(93.5 ± 2.3) points]and 84-96 points [(91.0 ± 3.9)points] respectively at the final follow-up,improved compared to the preoperative 42-61 points [(51.1 ± 6.2) points] and 46-68 points [(55.2 ± 7.0) points] (both P ＜0.05).Conclusion Arthroscopic Ethibond suture and anchor fixation for avulsion fracture of the ACL tibial insertion is an effective procedure with the advantages of small trauma,reliable fixation,good functional recovery and satisfactory clinical effect.

Objective To investigate the prevalence and risk factors of mild cognitive impairment (MCI) among the old people in Chongqing, China. Methods From October to November, 2015, 1850 persons more than 60-year-old in Chongqing were cluster sampled. They were investigated with self-made general situation questionnaire, Mini-Mental State Examination (MMSE), Instrumental Activity of Daily Living Scale (IADL) and Geriatric Depression Scale (GDS) through face-to-face interview. Enumeration data were tested withχ2 test and multiple Logistic regression. Results MCI prevalence was 11.73%in the old people in Chongqing, and various with the residential re-gions, ages, marital status, literacy, career, smoking, drinking, seafood-eating, egg-eating, exercising, intensive labor, low intensity of labor, housework, outdoor activities, Mahjong/chess/cards playing, TV-watching/radio-listening/newspaper-reading, social activities, obesity, hy-pertension, diabetes, stroke, hyperglycemia, cerebrovascular insufficiency and depression (χ2>4.092, P<0.05). According to multiple Logis-tic regression, living in rural areas, aging, celibacy, obesity, hypertension and depression were the risk factors of MCI;while middle school and above years of schooling, mental workers, smoking cessation, frequent seafood-eating and egg-eating, exercising, daily intensive labor and low intensity of labor, daily and sometimes housework, daily and weekly outdoor activities at least once, daily Mahjong/chess/cards playing and daily TV-watching/radio-listening/newspaper-reading were the preventing factors. Conclusion The morbidity of MCI is high in the old people in Chongqing. It is necessary to take effective intervention in view of the related factors of MCI as early as possible, to delay or prevent the development of MCI to dementia.

Objective To study the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with biliary and pancreatic diseases under the concept of enhanced recovery after surgery (ERAS). Methods 320 patients were enrolled in ERCP operation. Both ERAS elderly group (experimental group A, n = 58, above 75 years) and young and middle-aged group (control group B, n=202,below 60 years)underwent enhanced recovery after surgery,meanwhile traditional elderly group(control group C, n = 60, above 75 years) received traditional perioperative management. It had compared multiple clinical indexes between group A with B and group A with C during the preoperative, intraoperative, and postoperative period. Results The incidence rate of cholangiocarcinoma, multiple complications, nutrition screening ≥ 3 points, ASA scored III degree and Child-Pugh scored A-level in preoperative ERAS elderly patients were higher than that of the young and middle-aged group (P < 0.05); And its incidence rate of nausea and vomiting and abdominal pain,nutritional screening < 3 points and ASA scored I degree were lower than that of the middle-aged group (P < 0.05);the fasting and water- deprivation time of the ERAS elderly group was shorter than that of the traditional elderly group (P < 0.05). The intraoperative operation time of the elderly ERAS group was slightly longer than that of the traditional elderly group (P < 0.05). The duration of electrocardiographic monitoring and the first aerofluxus time of the elderly patients with ERAS were longer than that of the young and middle-aged group (P < 0.05). The success, failure rate, and complication rate of the elderly patients with ERAS were 91.38% (53/58) and 8.62% (5 /58), 3.45% (2/58), meanwhile the young and middle-aged group were 96.53% (195/202), 3.47% (7/202), and 4.95% (10/202), and with no statistical difference (P > 0.05). The mild pain in ERAS elderly group was more than that of in traditional elderly group, while the moderate, and severe pain was less than that of traditional elderly group (P < 0.05); The opioid use rate, endoscopic nasobiliary indwelling, first-time ambulation and aerofluxus, total hospitalization, and postoperative hospitalization time of ERAS elderly group was less than the traditional elderly group (P < 0.05). Conclusions With ERAS, the treatment effect of ERCP in elderly patients is similar to that in young and middle-aged people, and it has good safety and effectiveness.

Objective To collect cases of non-violent death occurred in custody for analyzing the forensic characteristics and related influencing factors.Methods Sixty-three cases of non-violent death among detainees in custody that handled by a forensic science center from 2000 to 2015 were collected.The type,onset season,medical history,clinical manifestation,treatment and duration of related fatal diseases were analyzed retrospectively.Results The deaths due to diseases in custody were common in male,and with a high incidence in middle aged adults.The most common cause of death was cardiac death (50.8％).Chronic inflammatory diseases such as gastrointestinal perforation,pulmonary tuberculosis,pneumonia,hepatitis and pancreatitis,were common.There was a peak incidence in summer.The acute symptoms included sudden onset during sleep and sudden apsychia,and emesis,abdominal pain,fatigue,chest tightness,shortness of breath,fever and anorexia were the most common chronic symptoms.Conclusion The management system,custody condition,medical level and rescue rudiment of custody still need improvements.It should be pay more attention to collecting the information of medical history,autopsy,histological examination and toxicological analysis,etc.