Objective To evaluate the efficacy and adverse reactions of Navelbine(NVB)in the treatment of recurrent and metastatic breast cancer.Methods 34 patients with recurrent and metastatic breast cancer were treated with Navelbine in this clinical study,and 16 patients were treated by the NP(DDP+NVB)regimen,12 patients by the NA(ADM+NVB)regimen,6 patient by single-agent NVB.34 patients received above regimens for two cycles(3～4 week a cycle).Result The overall response rate(CR+PR)was 35.3%,clinical benefit rate(CR+PR+SD≥6 months)44.1%,disease contrrol rate(CP+PR+SD)58.8%,the median time to failure 3.4 months(range:0.7～11 months),the median time to progression(TTP)3 months(range:0.8～11 months),and the median duration of response(CP+PR)5 months(range:2～11 months).The main side effect of the therapies is bone marrow depression,and the grade Ⅲ～Ⅳ leucopenia is 35.3%.Conclusion Single Navelbine and Navelbine plus DDP(or ADM)are effective and well tolerated treatments in patients with recurrent and metastatic breast cancer.

Objective:To investigate the clinical significance of the primary tumor size in patients with endometrial carcinoma (EC).Methods:A total of 385 patients with EC admitted to Peking University People's Hospital from January 2006 to December 2016 with complete follow up data were selected, whose tumor size data before biopsy were retrospectively studied.Results:(1) The mean diameter of the primary tumor was (3.6±1.8) cm (range: 1-15 cm). And 48 cases were 0-<2 cm, 78 cases were 2-<3 cm, 92 cases were 3-<4 cm, 73 cases were 4-<5 cm, 94 cases were ≥5 cm. The diameter of the tumor was associated with age <60 years old, premenopause, CA 125≥35 kU/L, non-parturition, poor differentiation, stage Ⅲ-Ⅳ, depth of myometrial infiltration ≥1/2, cervical interstitial involvement, adnexal metastasis and lymph node metastasis (all P<0.05), but not associated with body mass index, hypertension, diabetes mellitus, pathology, lymph-vascular space invasion (all P>0.05). (2) Among the 334 patients underwent lymphadenectomy, 45 (13.5%, 45/334) cases with lymph node metastasis were observed. Stratified analysis showed that lymph node metastasis and recurrence rate of patients with EC gradually increased with the increase of tumor size ( P<0.05). Adopting 2, 3, 4 and 5 cm as cut-off values of tumor size, there were significant differences in the rate of lymph node metastasis and recurrence among them observed ( P<0.05), except for lymph node metastasis rate and recurrence rate when the cut-off value was 2 cm ( P>0.05). (3) An receiver operating characteristic (ROC) curve analysis showed that a tumor diameter of 4.25 cm was the cut-off prognostic value to predict lymph node metastasis and recurrence of EC. Conclusions:Tumor diameter is significantly correlated with lymph node metastasis and recurrence in patients with EC. Tumor size should be considered in determining the scope of surgery and adjuvant therapy.

Objective: Aimed to construct an immune-related risk signature and nomogram predicting endometrial cancer (EC) prognosis. Methods: An immune-related risk signature in EC was constructed using the least absolute shrinkage and selection operator regression analysis based on The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. A nomogram integrating the immune-related genes and the clinicopathological characteristics was established and validated using the Kaplan-Meier survival curve and receiver operating characteristic (ROC) curve to predict the overall survival (OS) of EC patients. The Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) R tool was used to explore the immune and stromal scores. Results: CCL17, CTLA4, GPI, HDGF, HFE2, ICOS, IFNG, IL21R, KAL1, NR3C1, S100A2, and S100A9 were used in developing an immune-related risk signature evaluation model. The Kaplan-Meier curve indicated that patients in the low-risk group had better OS (p<0.001).The area under the ROC curve (AUC) values of this model were 0.737, 0.764, and 0.782 for the 3-, 5-, and 7-year OS, respectively. A nomogram integrating the immune-related risk model and clinical features could accurately predict the OS (AUC=0.772, 0.786, and 0.817 at 3-, 5-, and 7-year OS, respectively). The 4 immune cell scores were lower in the high-risk group. Forkhead box P3 (FOXP3) and basic leucine zipper ATF-like transcription factor (BATF) showed a potential significant role in the immune-related risk signature. Conclusion Twelve immune-related genes signature and nomogram for assessing the OS of patients with EC had a good practical value.

Objective: This study aims to analyze factors associated with lymphovascular space invasion (LVSI) and evaluate the prognostic significance of LVSI in Chinese endometrioid endometrial cancer (EEC) patients. Methods: Five-hundred eighty-four EEC patients undergoing surgery in our center from 2006 to 2016 were selected for analysis. Univariate analysis and multivariate logistic regression were used to examine relevant factors of LVSI. To evaluate the prognostic role of LVSI, survival analyses were conducted. In survival analyses, both multivariate Cox regression and propensity score matching were used to control the confounders. Results: The incidence of LVSI was 12.16% (71/584). Diabetes history (p=0.021), lymph node metastasis (p=0.005), deep myometrial invasion (p<0.001) and negative PR expression (p=0.007) were independently associated with LVSI. Both Kaplan-Meier method and univariate Cox regressions showed LVSI negative and positive cases had similar tumor-specific survival (TSS) and disease-free survival (DFS). After adjusting for the influence of adjuvant therapy and other clinicopathological factors with multivariate Cox regressions, LVSI still could not bring additional survival risk to the patients (p=0.280 and p=0.650 for TSS and DFS, respectively). This result was verified by Kaplan-Meier survival analyses after propensity score matching (p=0.234 and p=0.765 for TSS and DFS, respectively). Conclusion LVSI does not significantly compromise the survival outcome of Chinese EEC patients.

Objective To explore the psychological stressors and coping styles of nurses in primary hospital hemodialysis room. Methods Forty two nurses in primary hospital hemodialysis room were selected as research objects, and then we investigated their psychological stressors, influencing factors and coping styles. Results The scores of health dimension, working dimension, economical dimension were (3. 48 ± 0. 64), (3. 19 ± 0. 45) and (3. 03 ± 0. 50), and they were the main psychological stressors. Age, education, job title and work experience were the influencing factors. Optimism, confrontation, self-reliance and seeking support were the main coping style. Abreaction, bow to fate, escapism and masking were useless. Conclusions Medical institutions need to take effective measures in view of the pressure source, and reduce the nurse′s psychological stress and maintain their physical and mental health.

Objective: To explore the association between sleep quality and dry eye symptoms in adolescents,so as to provide the evidence for reducing the prevalence of dry eye symptoms. Methods: The study population was adolescents aged 12-24 years from the Psychology and Behavior Investigation of Chinese Residents (PBICR) survey, which was conducted from 20 June to 31 August 2022. A stratified random sampling and quota sampling method was used to select 6 456 adolescents within mainland China. The Ocular Surface Disease Index (OSDI) and Brief version of the Pittsburgh Sleep Quality Index (B-PSQI) were used to assess dry eye symptoms and sleep quality. Multiple Logistic regression model was used to explore the relationship between sleep quality and dry eye symptoms in adolescents. The influence of gender on the association was explored by using interaction terms. Results: A total of 2 815 adolescents reported having dry eye symptoms, with a prevalence of 43.6%. Logistic regression analysis results showed an increased risk of exacerbation of dry eye symptoms in adolescents with poor sleep quality. The OR (95% CI ) for mild, moderate, and severe dry eye symptoms groups were 1.39(1.16-1.67), 1.52(1.28-1.81), and 2.35(2.02-2.72), respectively, compared with the ocularly normal group ( P <0.05). There was a significant interaction between sleep quality and gender on dry eye symptoms in adolescents ( P <0.01). Conclusions Sleep quality is associated with dry eye symptoms in adolescents, and those with poor sleep quality have a higher risk of dry eye symptoms. The effect of sleep quality on dry eye symptoms is greater in boys.

Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.
Abscess ; Drainage ; Humans ; Rectal Fistula ; Suture Techniques ; Sutures

Objective To establish a real-time quantitative PCR (RT-PCR) preliminary screening method for rapid detection of Brucella.Methods Based on the nucleotide sequence encoding Brucella's outer membrane proteins omp10 and omp31,four primers and probes of omp10,omp10-1,omp31 and omp31-1 were designed.The primers and probes were used to detect 19 strains of 6 categories of Brucella DNA of known organisms,10 strains of Brucella DNA that were isolated from Yuxi of Yunnan.And 224 negative Brucella DNA,including 35 strains of Bartonella DNA,103 strains of the Lord Komori enterocolitis DNA (including 4 parts of O ∶ 3 and 9 parts of O ∶ 9) and 86 samples of hybrids bacteria DNA.Then the specificity of primers and probes were evaluated based on the test results.Results The DNA of 19 standard Brucella strains could be amplified by omp10 and omp10-1,and the peak time and amplification curve of omp10 is better than omp10-1,and the DNA of negative control strains could not be amplified by omp10.The DNA of 16 standard Brucella strains could be amplified by omp31-1.The DNA of standard Brucella strains could not be amplified by omp31.The average Ct values of 10 strains of Brucella DNA which were isolated from Yuxi of Yunnan that were detected by omp10,omp10-1 and omp31-1 respectively were 19.87,19.14 and 17.52.Conclusion Omp10 has strong specificity and only specific for Brucella,so it can be used for rapid detection of Brucella.

Objective To investigate whether the host animals of Yulong plague foci carry Yersiniapestis phage,and to identify isolated plague phage.Methods Rodent specimens were collected in 5 villages of Yulong plague foci in spring and autumn of 2016,respectively.Vaccine strain EV76 was used as breeding bacteria.Phage was isolated from the specimens by double-layer plate method and plaque morphology was identified.Results ① Totally 409 samples collected in spring failed in phage isolation.A total of 40 of Yersinia pestis phages were isolated from 444 samples in autumn,and the total isolation rate was 9.01％ (40/444).② The Yersinia pestis phages were isolated in all of 5 villages,and the isolation rate was of no significant difference (x2 =5.055,P ＞ 0.05).③ Of the 40 strains of phage,37 strains were isolated from Apodemus chevrieri,2 strains from Eothenomys Miletus and 1 strain from Crocidura Dracula.④Based on the appearance,the plaque of the phage was divided into three:large (diameter 1.5-2.5 mm),middle (0.5-＜ 1.5 mm) and small (＜ 0.5 mm).Conclusion There is a higher number of plague phage in the host animals of the plague foci in Yulong County of Yunnan Province,the plaques are diverse in morphology,and their biological characteristics may be polymorphic.

The discussion on the connotation of children’s subjectivity is not only a response to the lack of children’s subjectivity at the current stage of health management, but also a reference for children’s medical science popularization. Based on the perspective of social critical theory, this study used empirical research methods to review the "Dream Medical College" project of Children’s Hospital of Fudan University. The current situation and influencing factors of health management experience of 1 520 children participating in the "Dream Medical College" project were analyzed. The study showed that 96.35% of 1 316 subjects had diagnosis and treatment experience in specialized hospitals, and the overall negative emotional performance was at a low level (0~12 points). There was significant correlation between diagnosis and treatment, invasive experience and children’s emotional performance (P<0.05). The study revealed that the diagnosis and treatment field is the main practice place of children’s health management, while the subjective of children with different diagnosis and experience perform significantly different. Children over 4 years old have better language anxiety than physical anxiety when receiving diagnosis and treatment. Although medical science popularization is an important practical form of children’s health management, it lacks the science popularization content of invasive diagnosis and treatment and emotional management, and creative popular science form is more suitable for children with long-term and frequent diagnosis and treatment experience.