Objective To evaluate the efficacy and safety of sorafenib in combination with interferon-alpha(IFN-α)as the first-line treatment in patients with advanced renal cell carcinoma.Methods Since Dec 2007 to Jun 2008,137 legal patients with advanced renal cell carcinoma (RCC)were enrolled in the trail from 22 hospitals in China.All the patients continuously received the treatment of sorafenib plus IFN-α untill disease progressed or patients were unable to tolerate.The primary end points were objective response,disease control rate and adverse effects rate.Results This interim analysis was based on the data collected from the study initiation date to 2009/3/20.The overall response rate(ORR),including complete response (CR) and partial response(PR),was 32.8%(45/137).The median follow-up time was 11.9 months,only 25 patients progressed at the cut off time.The most common adverse events were hand-foot skin reaction(48.2%),alopecia(23.4%),rash (20.4%),diarrhea(19.7 0A),fever(16.8%),lassitude(10.2%),etc.The incidence of 3 or 4 grade hand-foot skin reaction was 8.8%.Conclusions Sorafenib in combination with IFN-α as the firstline treatment in patient with advanced RCC could be effective and safe.

Objective To improve the teaching quality of Sex and Reproductive Health for college students.Methods From February 2008 to June 2010,the general elective course of SeX and reproductive health were offered for students from all the majors in Shanghai Jiao Tong University.The lessons were conducted in the form of lectures,group discussions,role-plays and debates.The self-designed questionnaires were respectively given out after the first class and at the end of the last class in order to have an understanding of the rate of the relevant knowledge known by the students and their suggestions.Results The rate of the relevant knowledge known by the students significantly increased.Some suggestions about the educational reform were received through questionnaire and educational feedback.Conclusion The reproductive health service is needed for college students.Group discussions and role-plays are ideal methods for interactive teaching.

ObjectiveTo develop the interacting learning mode in simulative situation on sex and health courses for college students and evaluate the effect of it.MethodsThe core curriculum for general education of sex and health was open to all the students in Shanghai Jiao Tong University from Feb.2010 to Jun.2011.The courses imported simulative-situation-learning method.At the end of the semester,the feedbaick and the suggestion of the students were collected and sorted.ResultsAll groups from the course involved the simulative situation seriously,which included homosexuality of college students,undesired pregnancy and contraception knowledge,etc.According to the feedback of the courses,most of the students acceptted this kind of teaching method.ConclusionInteracting learning in simulative situation can obviously increase the interest and enthusiasm of students.Meanwhile,the new courses not only improve students' understanding of knowledge,but also improve their communication skills and team work ability.

Objective To discuss the application of microsurgery in the treatment of male infertility.Methods From March 2007 to March 2012,there were totally 853 infertile men received microsurgical treatments in our department.Among them,344 patients with unilateral or bilateral varicocele underwent microsurgical varicocelectomy,60 underwent vasovasostomy (VV) and 192 underwent vastoepidystomy (VE)in microsurgical methods due to obstructive azoospermia.257 non-obstructive azoospermia (NOA) patients were performed microdissection of testicular sperm extraction (MD-TESE),at the same time,pathologic examination was done.Results ①For the varicocele patients,the pre-operative sperm density was (10 ±6) × 106/ml,the progressive sperm percentage was (16 ± 9)％.The post-operative density was (15 ± 8) ×106/ml,the progressive sperm percentage was (28 ± 14)％.The natural pregnant rate was 10.8％ (37/344).②In 60 patients undergone VV,the patent rate was 80.0％ (48/60),the natural pregnant rate was 35.0％ (21/60).In 192 VE patients,the patent rate was 53.1％ (102/192),the natural pregnant rate was 19.8％ (38/192).③In 257 NOA patients,the testicular volume,sperm retrieval rate of MD-TESE was significantly higher than that of conventional testicular sperm extraction (60.3％ vs.38.1％).Conclusion The microsurgery techniques in male infertility treatments could have some advantages such as explicit effects and decreased injuries.

Objective To observe the effect of different doses of atorvastatin combined with probucol on contrast induced acute kidney injury (CIAKI) and serum uric acid in elderly patients.Methods Totally 121 cases admitted for coronary angioplasty were randomly divided into three groups.In standard combining treatment group (n＝35),atorvastatin 20 mg qn and probucol 0.25 g,tid were given with no loading dose intake before angioplasty.In intensively combined treatment group (n＝41),atorvastatin 40mg qn and probucol 0.25 g,tid were given with a loading dose of atorvastatin 40 mg and probucol 0.5 g at 2 hours before angioplasty.In intensive atorvastatin therapy group(n＝45),atorvastatin 40 mg qn were given,with a loading dose of atorvastatin 40 mg 2 hours before angioplasty.All patients were then evaluated 24 hours before and after angioplasty procedure,and their blood urea nitrogen (BUN),serum creatinine (Scr),serum uric acid (SUA),estimated glomerular filtration rate (eGFR) by modified diet in renal disease study (MDRD) method were tested.The serum and urine at 24 hours before and after operation were collected.Neutrophil gelatinase associated lipocalin (NGAL) were determinated by enzyme linked immunosorbnent assay (ELISA) method.Results After operation,eGFR was decreased in standard combining treatment group [(76.2±14.3) ml· min-1 · 1.73 m-2 vs.(71.9±17.9) ml· min-1 · 1.73 m-2,P＜0.05],while Scr,eGFR and uNGAL showed no changes in intensively combining treatment group and intensive atorvastatin therapy group (P＞0.05) ; BUN in the two groups was decreased [(5.6± 1.4)mmol/L vs.(4.7±0.9) mmol/L,(5.3±1.2) mmol/L vs.(4.8±1.2) mmol/L,P＜0.01,P＜0.05].SUA was reduced in intensively combining treatment group (P ＜ 0.05).uNGAL was increased in standard combining treatment group (P ＜ 0.05).Conclusions For elderly patients,intensive atorvastatin therapy and combining intensive treatment can both improve CIAKI.Only combination and intensive treatment benefit for decrease of uric acid.

Aim TostudytheeffectsofCuO,ZnOand TiO2 nanoparticles on the viability and metastatic po-tential of EC-9706 and EC-109 esophageal squamous carcinomacelllineinvitro.Methods Characteristics of CuO,ZnO and TiO2 nanoparticles were detected u-sing transmission electron microscope (TEM)and dy-namic light scattering (DLS ).EC-9706 and EC-109 cells were treated with different concentrations of CuO, ZnO and TiO2 (5 ~80 mg · L-1 ).The cell prolifera-tion was analyzed by MTT assay.The cell cycle and apoptotic rates were determined by flow cytometry (FCM).The cell invasion was assayed in Transwell chambers.The expression of Bcl-2 and caspase-3 pro-tein in cells was detected by Western blot method.Re-sults CuO,ZnOandTiO2nanoparticleswerespheri-cal with primary particle size 12,20. 6,12 nm.The particles were agglomerated in water and cell culture medium with negative charge.CuO and ZnO nanoparti-cles induced decreases in EC-9706 and EC-109 cell vi-ability dose-dependently.After exposed to increasing concentrations of CuO and ZnO nanoparticles,the cell cycle analysis revealed a decreasing proportion of cells in G2/Mand S phase,and up-regulation of the cells in G0/G1 phase.Apoptotic cells also increased along with decreased cell invasion upon CuO and ZnO treatment. Nanoparticles treatment after 48 h, the activated caspase-3 expression quantity increased significantly and the Bcl-2 expression quantity decreased obviously (P<0. 05 )compared with control group.TiO2 nanop-articles had no obvious effect on the EC-9706 and EC-109 cell proliferation,cell cycle,apoptosis and inva-sion.Conclusion ComparedwithTiO2,CuOand ZnO nanoparticles can inhibit EC-9706 and EC-109 cell viability and metastatic potential,the mechanism of action involves cell cycle arrest in G0/G1 phase and apoptosis.These findings can help the development of nanoparticles as anti-cancer therapeutics for esophageal cancer.

Objective:To investigate the potential prognostic value of cyclin D1 expression in patients with locally advanced oral squamous cell carcinoma (OSCC) and its relationship with taxol (Docetaxel)/cisplatin plus 5-fluorouracil (TPF) induction chemothera-py. Methods:A total of 256 patients with locally advanced OSCC were selected from Shanghai Ninth People's Hospital of Shanghai Ji-ao Tong University School of Medicine between March 2008 and December 2010 as the objects of study in this prospective randomized clinical trial. The effect of TPF induction chemotherapy was investigated. Immunohistochemical staining against cyclin D1 was per-formed in the pretreatment biopsy specimen of the patients. The relationship between cyclin D1 expression and prognostic data of the TPF induction arm and control arm was analyzed. Results:Cyclin D1 expression was detected in 232 out of the 256 patients. Patients with low cyclin D1 expression showed significantly better overall survival (OS) (P=0.001), disease-free survival (DFS) (P=0.003), lo-coregional recurrence-free survival (LRFS) (P=0.004), and distant metastasis-free survival (DMFS) (P=0.001) than those with high cy-clin D1 expression. No significant differences existed in OS, DFS, LRFS, or DMFS between the patients with TPF induction chemother-apy and the control. Cyclin D1 expression levels were not predictive of the benefit from TPF induction chemotherapy in the overall pop-ulation. However, patients with nodal stage cN2 and high cyclin D1 expression, who were undergoing TPF chemotherapeutic regimen, showed significantly higher OS (P=0.024) and DMFS (P=0.024) than cN2 patients with high cyclin D1 expression but undergoing stan-dard surgical treatment. Conclusion:Cyclin D1 can be used as a prognostic biomarker for patients with locally advanced OSCC. Fur-thermore, cN2 OSCC patients with high cyclin D1 expression can receive long-term benefit from the addition of TPF induction chemo-therapy to standard surgical treatment.

Objective:To analyze the correlation between frailty and health literacy in elderly patients with chronic cardiac insufficiency.Methods:The convenience sampling method was used to select 290 elderly patients with chronic cardiac insufficiency who were hospitalized in the Department of Geriatrics and Department of Cardiovascular Medicine of a tertiary first-class hospital in Wuhu City from Mar 2022 to Jun 2022.The patients were investigated with the general information questionnaire,FRAIL scale,Health Literacy Management Scale,etc.Spearman analysis was used to analyze the correlation between frailty and health literacy.Binary logistic regression were used to analyze the risk factors of frailty in elderly patients with chronic cardiac insufficiency.Results:The incidence of frailty in elderly patients with chronic cardiac insufficiency was 22.8% .Spearman analysis showed that the total score of health literacy was negatively correlated with frailty(r=-0.291,P= 0.000).Results of binary logistic regression analysis showed that health literacy score(OR=0.419,95% CI:0.266-0.908),long-term insomnia(OR=6.466,95% CI:2.099-19.914),nutritional risk(OR=11.202,95% CI:3.983-31.508),depression risk(OR=10.014,95% CI:1.963-51.075),chronic disease types≥5(OR=12.784,95% CI:3.811-42.878),exercise self-efficacy(OR=0.512,95% CI:0.304-0.956),and chronic disease information acquisition ability(OR=0.512,95% CI:0.304-0.956)were independent predictors of frailty in elderly patients with chronic cardiac insufficiency(P＜0.05).Conclusions:The incidence of frailty in elderly patients with chronic cardiac insufficiency is high,and clinical staff should pay more attention to the elderly with frailty,especially patients with long-term insomnia,risk of nutrition and depression,coexistence of chronic diseases,low level of health literacy and exercise self-efficacy.Targeted measures should be actively taken to improve the quality of life of patients and reduce the readmission rate.

Objective To summarize the clinical features,serological features,blood transfusion protocols and treatment of 3 cases of passenger lymphocyte syndrome(PLS)after ABO-incompatibility liver and renal transplantation in our hospital,in order to provide guidance for comprehensive clinical understanding and recognition of this disease,especially early recogni-tion and treatment.Methods By collecting the basic information of the patients and the time of cross-matching incompatibility of homologous blood after transplantation,observing the skin yellow staining,detecting hemoglobin value and other hemolysis indexes,and blood group serological detection results before and after transfusion,the diagnosis and analysis were performed.The diagnosis and treatment effect of PLS were analyzed by collecting the clinical outcome information after immunization and blood transfusion.Results Three cases of ABO-incompatible liver transplantation showed decreased hemoglobin and hemoly-sis,incompatible cross-matching of homologous blood,and anti-A and anti-B IgG antibodies were confirmed by serological test.After treatment such as immunosuppression and plasma exchange,blood transfusion was effective,hemolysis was im-proved,and antibodies gradually disappeared.Conclusion ABO blood group antibody screening,unexpected antibody screening and direct antiglobulin test(DAT)should be performed regularly for ABO-incompatible liver and renal transplantation cases,in order to detect the PLS early.A series of laboratory tests related to PLS should be performed in time to diagnose and adjust the treatment plan,including transfusion strategy,when homologous cross-matching is incompatible.

Objective:To establish a LC-MS/MS method for determination of paraquat and diquat in plasma and urine samples.Methods:Plasma is precipitated by acetonitrile then diluent with phosphate buffer (pH=7) , urine is diluent with phosphate buffer (pH=7) , then diluent samples extracted with Oasis WCX solid-phase extraction column. Samples were analyzed using LC-MS/MS in multiple reaction monitoring (MRM) mode. The analytical column was XBridge?BEH-HILIC (100 mm×2.1 mm×2.5 μm) and the mobile phase were 100 mmol ammonium formate add 0.5% formic acid and acetonitrile. Paraquat was quantified by internal standard method and diquat by external standard method.Results:The calibration curves of paraquat and diquat were linear in the concentration range of 10.0~120.0 μg/L, the correlation coefficient (r) were 0.9985~0.9994. The limit of detection of paraquat in plasma and urine were 1.98 μg/L and 1.00 μg/L, respectively, the recovery rate were 100.2%~107.3%, the RSD were 1.6%~3.3%. The limit of detection of diquat in plasma and urine were 1.80 μg/L and 2.77 μg/L, respectively, the recovery rate were 85.3%~93.1%, the RSD were 1.8%~5.5%. Conclusion:This method is sensitive and accurate, and can simultaneously determine paraquat and diquat in plasma and urine.