Objective To compare the efficacy between californium?252 ( 252 Cf ) neutron intraluminal brachytherapy combined with external?beam radiotherapy with lead?shielding pelvic parallel opposing field technique and non?lead?shielding four?field box technique for cervical cancer. Methods A total of 52 patients with stage Ⅱa?Ⅲb cervical squamous cell carcinoma who were admitted to our hospital from 2004 to 2007 were enrolled as subjects and paired by clinical stage, age, tumor size, and degree of anemia. The 26 pairs of patients were divided into lead?shielding pelvic parallel opposing field group (lead?shielding group) and non?lead?shielding four?field box group (non?lead?shielding group). For all patients in both groups, 252 Cf neutron brachytherapy was added in external?beam radiotherapy. The local control (LC), overall survival (OS), and disease?free survival (DFS) rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The difference in the incidence of late complications was analyzed using the McNemar method. Results There were significant differences in 5?year LC, OS, and DFS rates between the lead?shielding group and the non?lead?shielding group (85% vs. 81%, P= 0?? 014;89% vs. 73%, P=0?? 013; 89% vs. 73%, P= 0?? 013 ). There was also significant difference in the incidence of late complications between the lead?shielding group and the non?lead?shielding group ( 12% vs. 23%, P=0?? 008). Conclusions When intraluminal brachytherapy combined with external?beam radiotherapy is used to treat cervical cancer, the centers of the front and back fields should be shielded by lead, regardless of whether the parallel opposing field technique or the four?field box technique is used.

OBJECTIVE:To study the formulation of Xiqingguo buccal tablet,optimize the proportion and quantity of main materials. METHODS:Using appearance,hardness,dissolution and taste as investigation indexes,orthogonal design was adopted to optimize the proportion and quantity of main thinner(lactose,mannitol),wetting agent(ethanol),lubricant(magnesium stea-rate),flavoring agent(aspartame),and critical relative humidity was detected. RESULTS:By wet granulation,the optimal formu-lation were as follows as the ratio of lactose and mannitol was 1:3,ethanol volume fraction was 60%,the dosage of menthol, magnesium stearate,aspartame and orange essence was 0.4%,0.9%,2.0%,0.4%;it was proven that the total score of 3 batches of samples were 2.67,2.67,2.70 (RSD=0.65%,n=3),respectively. The critical relative humidity of granule was 60%. CON-CLUSIONS:The Xiqingguo buccal tablet prepared by optimal prescription meets the requirements.

Objective To analyze the therapeutic effect of noninvasive mechanical ventilation in chronic obstructive pulmonary disease (COPD) patients with respiratory failure.Methods Sixty patients with COPD respiratory failure were randomly divided into two groups.30 cases in the conventional treatment group used conventional comprehensive therapy.30 cases in the nonfinvasive mechanical ventilation group were given noninvasive mechanical ventilation based on conventional treatment.The total effective rate,time to correct the abnormal breathing,hospitalization time were compared between the two groups.Before and after treatment,the arterial blood gas analysis indicators and heart rate,respiratory rate,probability,mortality for ventilator ventilation were compared in the two groups.Results The total effective rate of the noninvasive mechanical ventilation group was 96.67％,which was higher than 73.33％ of the conventional treatment group(x2 =6.405,P ＜ 0.05).The time to correct the abnormal breathing,hospitalization time of noninvasive mechanical ventilation group were (5.51 ± 1.41) d,(9.51 ± 2.13) d,respectively,which were shorter than (9.39 ± 2.56) d,(12.99 ± 3.57) d of the conventional treatment group (t =8.223,9.633,all P ＜ 0.05).Before treatment,the arterial blood gas analysis parameters and heart rate had no statistically significant differences between the two groups (all P ＞ 0.05).After treatment,the frequency of PaCO2,PaO2,heart rate and respiratory rate in the conventional treatment group were (60.45 ± 3.94)mmHg,(60.24 ± 4.12)mmHg,(92.58 ± 0.61)times/min,(22.45 ± 3.14)times/min,respectively,which in the noninvasive mechanical ventilation group were (52.24 ± 1.23) mmHg,(76.24 ± 5.26) mmHg,(83.92 ± 0.62) times/min,(17.26 ± 2.23) times/min,respectively,the differences between the two groups were statistically significant(t =5.133,3.734,5.166,6.360,all P ＜ 0.05).The invasive rate of invasive ventilator and mortality of noninvasive mechanical ventilation group were 3.33％ and 0.00％,respectively,which were lower than 20.00％,13.33％ of the conventional treatment group (x2 =7.214,6.247,all P ＜ 0.05).Conclusion Noninvasive mechanical ventilation is effective in treatment of patients with COPD respiratory failure,which can effectively improve the indicators of arterial blood gas and heart rate and respiratory rate,improve the prognosis of patients,improve the ventilation probability of invasive ventilator.

ObjectiveTo study the dynamic express of CD57 on T cell of PBMC and clinical significance in acute HIV infection.MethodsSeventeen patients with acute HIV infection were enrolled study randomly diagnosed from 2006.11 to 2009.12 and 15 healthy donors as control group.The PBMCs from 1th,3th and 6th during acute infection were collected.The proportion of CD3+CD57+T lymphocytes,CD3+ CD8+CD57 +T lymphocytes and CD3 + CD4 + CD57 + T lymphocytes were evaluated by flow cytometric analysis with three or double color staining.The relationship between the proportion of CD57+ T phenotypes and virus load and CD4+T cells count was analyzed.ResultsThe proportion of CD57+T lymphocytes in PMBC in 1th,3th and 6th during acute HIV acute was 15.24％ ±1.49％,13.51％ ±2.45％ and 14.65％ ±1.83％,respectively,and was higher than normal control group and the difference was significantly(P＜0.0001 ).The proportion of CD8+ CD57+T lymphocytes was 7.79％ ±2.10％ and 9.88％ ±2.36％ in 1th and 3th month during acute infection,respectively.The proportion of CD8+ CD57+T lymphocytes in 1th and 3th month during acute infection were positive relationship with virus load in corresponding time,and R2 was 0.3700 and 0.3768,and P value was 0.0096 and 0.0088,respectively.The proportion of CD8+CD57+T lymphocytes in the 1th and 3th month during acute infection was negative relationship with CD4+T lymphocytes count.The R2 was 0.3768 and 0.4235,and P value was 0.0215 and 0.0017,respectively.In 6 rapid progressors and 11 no rapid progressors on the 1th month after HIV infection,CD8+ CD57+T lymphocytes percentage was 11.20％±2.21％ and 6.16％ ±1.09％,respectively,and CD4+CD57+T lymphocytes percentage 2.79％ ±0.31％and 1.40％ ±0.30％,respectively.Both CD8+CD57+T and CD4+CD57+T in rapid progressors were higher than no rapid progressors,and P value was 0.0338 and 0.0106,respectively.ConclusionCD57+ T lymphocytes percentage in peripheral blood increase in acute HIV infection patients,in which the increasing CD8+CD57+T lymphocyte may mirror the dynamic of HIV replication and CD4+T cell count.The CD57 high express on T lymphocyte on the early HIV acute infection predicts rapid progression.

To explore the association between polymorphisms of transcription factor 7-like 2 gene (TCF7L2) and type 2 diabetes mellitus in Hefei district. The results suggest that the genetic variation DG10S478 in the TCF7L2 gene was not associated with type 2 diabetes mellitus in Hefei district ( P>0.05 ). However, its attribution to the susceptibility of type 2 diabetes mellitus in Hefei is not important.

Objective To compare the left ventricular function parameters of patients with sick sinus syndrome ( SSS ) and DDD pacemaker implantation during atrioventricular conduction ( AVC ) and right ventricular apex pacing ( RVAP ) mode . Methods Forty‐six consecutive patients with SSS who had undergone DDD pacemaker implantation were studied . Fifty volunteers were included as control group . Changing from AVC to RVAP mode ,the acute effect on echocardiographic parameters ,including LVEF , parameters of aortic/pulmonary artery pulse wave Doppler ,and parameters of left ventricular twist by speckle tracking imaging were measured respectively . Pacemaker implantation duration and cumulative ventricular pacing proportion ( Cum% VP) were recorded . The relationships of pacemaker parameter and above left ventricular function parameters were analyzed . Results Compared with control group ,values of peak rotation in LV apex and LV twist were significantly lower during AVC and RVAP mode . The value of peak rotation in LV base showed no significant difference between three groups .Apical‐basal rotation delay during RVAP was significantly longer than those during AVC and in control group respectively ( P <0 .05) . LVEF during RVAP decreased statistically ( P< 0 .05 ) ,but showed no difference during AVC , compared with the control group . The peak LV twist related positively with LVEF ,and negatively with Cum% VP . Conclusions RVA pacing decreases left ventricular function , which is independent of asynchrony contraction patterns caused by pacing . LVEF ,apical rotation and LV twist are more sensitive to demonstrate the LV dysfunction in patients with pacemaker implantation . LV twist related negatively with Cum% VP .

Objective To analyze the left ventricular (LV) diastolic function parameters of patients with sick sinus syndrome (SSS) and DDD pacemaker implantation during atrioventricular conduction (AVC) and right ventricular apex pacing(RVAP)mode.Methods Forty-six consecutive patients with SSS who had undergone DDD pacemaker implantation were studied.Fifty volunteers were selected as control group.Changing from AVC to RVAP mode,the acute effect on echocardiographic left ventricular diastolic function parameters,including mitral inflow PW parameters,mitral annulus tissue Doppler imaging parameters,left atrial volume index,and LV∕apical∕basal untwist parameters were measured.And all subjects were classified into normal diastolic function or three degrees of LV diastolic dysfunction.Results Compared with control group,both AVC and RVAP mode of patients with DDD pacemaker implantation resulted in the worsening of LV diastolic function as shown by(1) prolonged deceleration time of E wave, decreased descending slope of E wave,as well as decreased early diastolic velocity at the septal mitral annulus,(2) the decrease of LV∕basal∕apical untwist velocity,(3) the increase in the degree of diastolic dysfunction.Conclusions In patients with DDD pacemaker implantation,both AVC and RVAP mode are associated with the deterioration of LV diastolic function,which is particularly obvious in RVAP mode.

Objective To report a case of disseminated cryptococcosis with cutaneous manifestations and osteomyelitis. Methods and Results A 33 year old female was admitted due to multiple nodules and ulcers on the upper arms, shoulders, buttocks and thighs for one year. The patient was pregnant when admitted, and gave birth to a premature baby during her illness. The nodules increased half a month after delivery, which was suspected to be hematogenously disseminated pulmonary tuberculosis and was given anti tuberculous therapy for three months but failed. Physical examination showed there were 39 nodules or ulcers on the face, gum, trunk, buttocks and extre mities. The bone structure of the left tibia and fibula destroyed and a sinus developed on the left fibula. Microbiologic examination showed that lots of spores were seen in the smear of pus and necrotic tissues, which produced yeast like colonies in culture with positive urease and caffeic acid test. Cryptococcus neoformans, serotype A was identified by API yeast reaction band and serology. Inoculation with mice and rats showed that their brains, lungs and livers were involved easily. Further identification as C.neoformans var.neoformans was obtained based on sequence analysis of ribosomal internal transcribed spacer region 2. The anti tuberculous therapy was stopped and anti fungal therapy was initiated at once. Intravenous and topical amphotericin B in combination with fluconazole were chosen in the initial therapy and itraconazole for maintenance. The nodules disappeared after 30 days and the last ulcer in the left tibia healed completely after 200 days. The anti fungal therapy was discontinued after 277 days and the patient was completely cured.

Objective:To study the correlation between the time within the target range of blood glucose and the reduction of muscle mass in middle-aged and elderly patients with type 2 diabetes (T2DM).Methods:A total of 245 middle-aged and elderly T2DM patients admitted to the Second People′s Hospital of Hefei from December 2020 to December 2021 were selected. All enrolled patients wore MeiQi blood glucose monitor to obtain time in range (TIR), time above range (TAR), time below range (TBR), mean amplitude of glycemic excursions (MAGE), coefficient of variation (CV), blood glucose standard deviation (SD), largest amplitude of glycemic excursions (LAGE), which was for assessing blood sugar fluctuation. The incidence of muscle mass reduction and sarcopenia was statistically analyzed, and the differences invarious observation indicators between the muscle mass reduction group and the non muscle mass reduction group were compared. Spearman correlation analysis was used to investigate the correlation between clinical indicators and limb skeletal muscle mass index (ASMI), and logistic regression was used to analyze the influencing factors of muscle mass reduction in middle-aged and elderly T2DM patients.Results:The prevalence of muscle mass loss in 245 T2DM patients was 25.71%(63/245), and the prevalence of sarcopenia was 13.06%(32/245). There were statistically significant differences in age, gender, body mass index (BMI), blood phosphorus, homeostatic model assessment of insulin resistance (HOMA-IR), urine albumin creatine ratio (ACR), 25 hydroxyvitamin D, diabetes nephropathy (DN) patient proportion, ASMI, grip strength, and 5 sit up test times between the muscle mass reduction group and the non muscle mass reduction group (all P<0.05). The TIR of the muscle mass reduction group was lower than that of the non muscle mass reduction group, while the TAR and mean blood glucose (MG) were higher than those of the non muscle mass reduction group, with statistically significant differences (all P<0.05). ASMI was negatively correlated with age, males, and HOMA-IR (all P<0.05), but positively correlated with BMI and 25 hydroxyvitamin D (all P<0.05). ASMI was positively correlated with SD and TIR (mean P<0.05), and negatively correlated with CV, LAGE, TAR, and MG (all P<0.05). The results of univariate regression analysis showed that age, male gender, DN, and TAR were risk factors for muscle mass reduction, while BMI, 25 hydroxyvitamin D, and TIR were protective factors for muscle mass reduction (all P<0.05). After adjusting for other related factors, TIR remained a protective factor for decreased muscle mass (all P<0.05). Conclusions:TIR is an independent protective factor for muscle mass loss in middle-aged and elderly T2DM patients, and the incidence of muscle mass loss can be reduced by increasing TIR levels in clinical practice.

Objective To investigate the influence of evidence-based nursing training scheme on knowledge and nursing behavior of nursing staff concerning artificial airway management , and to observe clinical effect of the training .Methods 76 nurses in ICU in Department of Neurology were trained with evidence-based nursing of delicacy management of artificial airway .Their knowledge about artificial airway and normalization of nursing behavior were compared before and after the training .Meanwhile, occurrence rates of hospital acquired pneumonia (HAP) and ventilator associated pneumonia (VAP) of 88 patients with artificial airway before and after the training were compared .Results Before the training , scores of nurses′theoretical knowledge on normalized management of artificial airway were (69.05 ±5.09), while the scores were (89.05 ±4.13) after the training (t=-26.587, P<0.01).After the training, passing percentage of nursing operations of oral care after orotracheal intubation , airway suction , airbag pressure monitoring and dressing change after tracheotomy were 90.8%, 93.4%, 94.7%and 92.1%, all higher than the percentage before the training (χ2 =16.369, 11.878, 10.417, 11.207;P<0.01).After the training, occurrence rate of HAP and VAP in patients with artificial airway was both 16.7%, lower than before the training (χ2 =4.905, 4.795;P<0.05).Conclusions Evidence-based nursing training on standardized management of artificial airway can improve the nurses ′theoretical knowledge , standardize nursing behavior , decrease occurrence rate of HAP/VAP of patients with artificial airway , and provide scientific management strategies for nursing managers on delicacy management of artificial airway .