Objective To compare the surgical and functional outcomes of single-site (transumbilical two-port) intracorporeal purse-suturing (IP) and single-port extracorporeal knotting (EK) for laparoscopic pediatric inguinal hernia (PIH) repair.Methods Between June 2008 and December 2014,358 PIH children underwent lapamscopic inguinal herniorrhaphy,including 126 treated by single-site intracorporeal purse string stitching using a needle-holder (IP group),and 232 by single-port extracorporeal knotting using an inner two-hook needle with preperitoneal hydrodissection (EK group).Results In all patients laparoscopic procedures were completed successfully without conversion.The operating time in IP group was significantly longer than that in EK group [unilateral:(20.4 ± 2.1) min vs.(9.4 ± 1.3) min,t=-5.23,P＜0.01;bilateral:(31.3 ±2.9) min vs.(15.2±1.7) min,t=-4.22,P＜0.01)].The hospital stay were similar between the two groups [(2.35 ±0.25) d vs.(2.38 ±0.18) d,t =-0.062,P ＞ 0.05].Five cases had intraoperative hematoma in the IP group while none in the EK group.One each suffered from recurrence in IP group and EK group.Three postoperative hydroceles were seen in IP group and one in EK group.Subcutaneous knot granulomas were seen in two in EK group.Conclusions Both IP and EK laparoscopic procedures are safe and feasible.With the assistance of preperitoneal hydrodissection technique,single-port laparoscopic EK herniorraphy is superior to single-site IP repair in easy performance and shorter operation time.

Objective To discover the existing problems and provide appropriate suggestions and countermeasures through the quality control inspection.MethodsA comprehensive quality control inspection was conducted for the radiotherapy equipment in 45 hospitals in Zhejiang province.The physical,technical,clinical and radiotherapy process and the parameters related to quality control were evaluated.Results As of December 31,2017,a total of 62 linear accelerators from 45 hospitals have been assessed.In the radiotherapy process,multiple quality control problems were identified in terms of radiotherapy equipment configuration,clinical work quality,radiotherapy technology and personnel qualifications.Besides,unreasonable equipment configuration,shortage of radiotherapy staff,clinical work flow and the quality assurance of physical radiotherapy remained to be resolved.Conclusion Regular quality control of radiotherapy plays a pivotal role in ensuring the accuracy,effectiveness and medical safety of radiotherapy.

Objective:To investigate the radiotherapy discipline construction and existing problems in non-public hospitals in Zhejiang province and put forward suggestions for improvement.Methods:In 2022, on-site inspection and investigation were carried out in 14 non-public hospitals in Zhejiang province, including equipment configuration and source, discipline setting, personnel qualification and professional experience, academic leaders and admission of patients, etc. Results:For 14 non-public hospitals in Zhejiang province, 19 treatment equipment, 15 positioning equipment and 77 quality control equipment were equipped, and a total of 249 radiotherapy practitioners were employed. A total of 4 224 patients were admitted throught 2022.Conclusion:Multiple problems exist in non-public radiotherapy hospitals in Zhejiang province, such as unscientific discipline setting, fewer professionals, lack of personnel training, unclear management mode, unqualified qualification of partial radiotherapy doctors, and insufficient refinement of clinical quality management, which need to be further improved.

Recently, great breakthroughs have been made in the treatment of melanoma with immune checkpoint inhibitors. However, only a small proportion of patients show a long-lasting response to immunotherapy, and risks of immune-related adverse events and drug resistance have been also increasing along with the emergence of combination treatment. This review summarizes biomarkers related to the efficacy of immune checkpoint inhibitors in the treatment of melanoma, aiming to predict and screen out patients who may benefit from immunotherapy, guide individualized clinical treatment, and reduce the occurrence of drug resistance and adverse reactions.

Objective: To explore the interrelationships among fathers’ parenting effectiveness, urban children’s sociality and the acceptance of “second-born children” by children (including only children and “first-born children”), and to provide a reference for interventional measured for improving children’s acceptance rate of "second-bron children". Methods: Stratified cluster sampling method was used to select 3 to 9-year-old 778 only children and “first-born children” in two kindergartens and grades 1-3 of two primary schools in a city, and the children and their fathers were investigated with questionnaires survey regarding general information of both fathers and children, the acceptance degree of “second-born children”, the sociality of children and the parenting effectiveness of fathers. Results: Children in different grades had different acceptance levels of “second-born children” and the difference was statistically significant (F=2.89，P<0.05). Correlation analysis showed that the acceptance of “second-born children” was negatively correlated with the interaction between the only children and “first-born children”, and positively correlated with the prosocial behavior of the only children and “first-born children”, both of which are statistically significant (r=-0.10，0.10,P<0.01). Father’s role efficacy was negatively correlated with onlychildren and “first-born-children” peer interaction problems(r=-0.15), and positively correlated with prosocial behavior(r=0.32), both of which were statistically significant (P<0.01). The structural equation model of father’s parenting effectiveness, children’s sociality and acceptance of “second-born children” showed that low father’s parenting effectiveness could positively predict children’s peer communication problems and negatively predict children’s prosocial behavior, and thus children’s peer communication problems could negatively predict the acceptance degree of only children and “first-born children” to “second-born children”, and prosocial behaviors could positively predict the acceptance degree of “second-born children”. Conclusion Promoting father’s parenting efficiency can facilitate the social development of children and the acceptance of siblings.It’s recommended that fathers actively participate in specific parenting matters for the only child and "one child",and consciously improve parenting effectiveness.

CD146 is a newly identified endothelial biomarker that has been implicated in angiogenesis. Though in vitro angiogenic function of CD146 has been extensively reported, in vivo evidence is still lacking. To address this issue, we generated endothelial-specific CD146 knockout (CD146(EC-KO)) mice using the Tg(Tek-cre) system. Surprisingly, these mice did not exhibit any apparent morphological defects in the development of normal retinal vasculature. To evaluate the role of CD146 in pathological angiogenesis, a xenograft tumor model was used. We found that both tumor volume and vascular density were significantly lower in CD146(EC-KO) mice when compared to WT littermates. Additionally, the ability for sprouting, migration and tube formation in response to VEGF treatment was impaired in endothelial cells (ECs) of CD146(EC-KO) mice. Mechanistic studies further confirmed that VEGF-induced VEGFR-2 phosphorylation and AKT/p38 MAPKs/NF-κB activation were inhibited in these CD146-null ECs, which might present the underlying cause for the observed inhibition of tumor angiogenesis in CD146(EC-KO) mice. These results suggest that CD146 plays a redundant role in physiological angiogenic processes, but becomes essential during pathological angiogenesis as observed in tumorigenesis.
Animals ; CD146 Antigen ; genetics ; metabolism ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; Female ; Fibrosarcoma ; metabolism ; pathology ; Male ; Melanoma, Experimental ; metabolism ; pathology ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; NF-kappa B ; metabolism ; Neovascularization, Physiologic ; drug effects ; Phosphorylation ; drug effects ; Proto-Oncogene Proteins c-akt ; metabolism ; Retinal Vein ; growth & development ; pathology ; Signal Transduction ; drug effects ; Transplantation, Homologous ; Vascular Endothelial Growth Factor A ; pharmacology ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism