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.

OBJECTIVETo develop a solvent desorption gas chromatographic method for determination of n-pentanol in the workplace air.

METHODSn-Pentanol in the workplace air was collected with activated carbon tubes, desorbed with 2% 2-propanol in carbon disulfide, separated with a nitroterephthalic acid-modified FFAP capillary column, and detected with flame ionization detector.

RESULTSThe limit of detection was 0.2 mg/L; the lower limit of quantification was 0.6 mg/L; the linear range was 0.6-4072.0 mg/L. The minimum detectable mass concentration was 0.2 mg/m3 for 1.5 L of air sample. This method was highly repeatable. The relative standard deviations were 2.3%-5.4%. The average desorption efficiencies were 86.9%-94.2%. The absorption efficiencies were 100%. The breakthrough volume was above 8.0 mg in 100-mg activated carbon. The samples in activated carbon tubes could be stored for at least 14 days at room temperature.

CONCLUSIONThe method is feasible for determination of n-pentanol in the workplace air.

2-Propanol ; Air Pollutants, Occupational ; analysis ; Carbon Disulfide ; Charcoal ; Chromatography, Gas ; Limit of Detection ; Pentanols ; analysis ; Solvents ; Workplace

A new type of surface plasmon resonance ( SPR) spectroscopy system was designed and built. Here, a kind of dual photocell sensor was developed as a detection device to achieve a rapid measurement of SPR angle within a certain range. This SPR system was combined and integrated with electrochemical workstation to obtain a new type of electrochemistry-time-resolved SPR ( EC-TR-SPR ) instrument via instrumental technique. This EC-TR-SPR instrument was used to characterize the electrochemical polymerization process of aniline to validate the spectroscopic characteristics. Applications of transient electrochemical characterization methods, including chronoamperometry and differential pulse voltammetry, confirmed the time resolution and the applicability of this instrument system toward the steady state and transient electrochemical methods upon small molecular reactions. The experiment results showed that this EC-TR-SPR possessed the time resolution up to 10000 times per second (0. 1 ms), and could be used to real-time investigate the doping and de-doping of polymerization process of aniline monomer as well as the prepared polyaniline film, which could not be discriminated on a conventional electrochemical current-time curve. .

Activity is the basic unit of teaching. Task-based teaching activity is popular because it emphasizes "learning by doing". Based on the activity theory, this paper designs a task-based teaching triangle model for TCM ESP course, and applies it to a TCM ESP course Introducing TCM Culture in English. An empirical study of task-based teaching activity is carried out by analyzing the subject, determining the object, employing tools, setting rules, clarifying the division of labor, constructing the community, focusing on the results, and enriching evaluation methods. It is proved that the application of the model is helpful to improve students' learning initiative, enrich their TCM English knowledge structure, enhance their TCM English application ability, and optimize TCM English teaching effect.

Objective: Heart failure (HF) patients are usually associated with liver function impairment, Child-Turcotte-Pugh (CTP) scores can evaluate liver function, but its effect in HF patients has been unclear. We want to study the application of CTP scores in predicting the risk of death for in-hospital HF patients. Methods: A total of 1180 consecutive in-hospital HF patients were enrolled. According to CTP scores evaluated liver function at admission, the patients were divided into 3 groups: CTP grade A group, n=951, CTP grade B group, n=206 and CTP grade C group, n=23. The endpoint of this study was all-cause death. Results: There were 180 patients died at 1 year follow-up period, the in-hospital and 1 year mortalities were increased with the elevated CTP grades accordingly: for in-hospital mortalities in CTP grade A, B and C groups were (0.8%, 11.7% and 56.5%) respectively, P< 0.001; for 1 year mortalities were (9.6%, 34.5% and 78.3%) respectively, P< 0.001. Multivariable Cox regression analyses indicated that the higher CTP grades, the higher risk of in-hospital and 1 year mortalities in HF patients. The area under curve for CTP scores in predicting the in-hospital and 1 year mortalities were 0.88 and 0.74 respectively. Kaplan-Meier survival analysis presented that the patients with improved CTP scores from grade B or C to grade A at discharge had the higher 1 year survival rate than those without improvement, P=0.028.
Conclusion: CTP scores may independently predict the risk of death for in-hospital HF patients, the levels of CTP scores might be used for evaluating the efficacy of in-hospital treatment.

OBJECTIVETo develop and test a scoring system to predict the risks of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy(PD).

METHODSClinic data and postoperative complications of the 445 consecutive patients who underwent a PD procedure between January 2008 and April 2015 in Peking University First Hospital were retrospectively collected and analyzed.The patients were randomly selected to modelling and validation sets at a ratio of 3∶1, respectively.The patient data were subjected to univariate and multivariate analysis in the modelling set of patients.A score predictive of POPF was designed and tested in the validation set.

RESULTSPOPF occurred in 88 of 334 patients(26.4%) in the modelling set.The multivariate analysis showed that body mass index (BMI, P<0.01) and pancreatic duct width(P=0.001) are associated with POPF independently.A risk score to predict POPF was constructed based on these factors and successfully tested.The area under the receiver operating characteristic curve were 0.829(95% CI: 0.777-0.881) on the modelling set and 0.885(95% CI: 0.825-0.945) on the validation set, respectively.

CONCLUSIONSBMI and pancreatic duct width were associated with POPF after PD. The preoperative assessment of a patient's risk for POPF is feasible.The present risk score is a valid tool to predict POPF in patients undergoing PD, to make the selection on anastomosis types, and to take precautions against POPF.

Anastomosis, Surgical ; Body Mass Index ; Humans ; Intestines ; surgery ; Multivariate Analysis ; Pancreas ; pathology ; surgery ; Pancreatic Ducts ; pathology ; Pancreatic Fistula ; pathology ; Pancreaticoduodenectomy ; adverse effects ; Postoperative Complications ; Postoperative Period ; ROC Curve ; Retrospective Studies ; Risk Factors

Objective To analyze the factors affecting the prognosis of patients with pulmonary sarcomatoid carcinoma (PSC) and construct a nomogram prediction model for the prognosis of PSC patients. Methods Based on the SEER database, 1671 patients diagnosed as PSC from 1988 to 2015 were collected and divided into modeling group and validation group according to the ratio of 7:3. Univariate and multivariate Cox regression analysis were performed in the modeling group to explore independent risk factors affecting the prognosis and construct a nomogram survival prediction model. The consistency index and calibration curve were used for verification in the modeling group and the test module respectively. Results Age, gender, histological type, TNM stage, tumor diameter > 50mm, surgery, radiotherapy and chemotherapy were independent factors that affected the prognosis of PSC patients. The nomogram prediction model was constructed and verified based on independent factors. The C indexes of the modeling group and the test model were 0.790 (95%CI: 0.776-0.804) and 0.781 (95%CI: 0.759-0.803), respectively. The calibration curves of the modeling group and the test model indicated that the predicted survival rate was basically the same as the actual survival rate. Conclusion The nomogram prediction model constructed based on the results of multivariate analysis can predict the prognosis of PSC patients, and has high accuracy and consistency.

Objective:To explore the inhibitory mechanism of herb cake-partitioned moxibustion on tumor growth in colitis-associated colorectal cancer(CAC)based on histone lysine demethylase 4D(KDM4D). Methods:Inbred male Sprague-Dawley rats were randomly divided into a normal group,a CAC group,a herb cake-partitioned moxibustion group,and an inhibitor group.Except the normal group,rats in the other three groups were treated with azoxymethane(AOM)combined with dextran sulfate sodium(DSS)to make CAC rat models.Rats in the normal group and the CAC group did not receive interventions;rats in the herb cake-partitioned moxibustion group received moxibustion at Qihai(CV6)and bilateral Tianshu(ST25),2 cones for one point each time,once a day for 30 d with 1-day rest every week;rats in the inhibitor group received intraperitoneal injection of KDM4D inhibitor,5-chloro-8-hydroxyquinoline(5-c-8HQ),once a day for 30 d.After intervention,the general condition,colon length,tumor number and volume,and histopathological colon changes were observed.The expression of adenomatous polyposis coli(APC),axis inhibitor(Axin),cyclin D1,matrix metalloproteinase(MMP)-7 and MMP-9 mRNAs were detected by real-time quantitative polymerase chain reaction.The proliferating cell nuclear antigen(PCNA),cleaved caspase3,KDM4D,APC,and Axin proteins were detected by immunohistochemistry. Results:Compared with the normal group,the general condition was poor,the colon length was significantly shortened(P<0.01),the number and volume of colonic tumors were increased(P<0.01),the structure of glandular duct was obviously disordered with"back-to-back"and cowall phenomenon,and also high-grade adenocarcinoma formed;the protein expression levels of PCNA and KDM4D were significantly increased(P<0.01),while cleaved caspase3,APC,and Axin were significantly reduced(P<0.01);the mRNA expression levels of cyclin D1,MMP-7,and MMP-9 were significantly increased(P<0.01),while APC and Axin were significantly reduced(P<0.01)in the CAC group.Compared with the CAC group,the general condition was improved,the length of colon was significantly increased(P<0.01),the number and volume of the colonic tumors were reduced(P<0.05),and the colon tissues showed epithelial cell proliferation with enlarged and deep staining nuclei,dysplasia and inflammatory cell infiltration;the protein expression levels of PCNA and KDM4D were significantly reduced(P<0.01),while the cleaved caspase3,APC,and Axin were significantly increased(P<0.01);the mRNA expression levels of cyclin D1,MMP-7,and MMP-9 were reduced(P<0.05),while the APC and Axin were increased(P<0.05)in the colon tissues of rats in the herb cake-partitioned moxibustion group and the inhibitor group. Conclusion:Herb cake-partitioned moxibustion regulated abnormally expressed KDM4D in CAC rats,activated APC and Axin,the upstream molecules of Wnt/β-catenin pathway,inhibited abnormally activated downstream molecules of Wnt/β-catenin pathway.This may be a key mechanism of herb cake-partitioned moxibustion in inhibiting CAC tumor growth.

Space reduction after the premature loss of the second primary molars is one of the important factors affecting the occurrence of malocclusion, often increasing the demand for orthodontic treatment. It has great significance to select and apply appropriate appliances to maintainthe space soon after the premature loss of the second primary molars. The space should be maintained until the adjacent teeth and the successors erupt successfully. This review summarizes the selection and clinical application of the space maintainer for the premature loss of the second primary molars in different periods, to improve dentists′ awareness of the importance of space maintainers and to provide advises for clinical choices.

Objective: To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. Materials and Methods: Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. Results: Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825–0.910) in the training cohort and 0.890 (0.844–0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. Conclusion The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.