Objective:To explore the clinical effect of lentinan injection combined with recombinant human endostatin in treatment of gastric cancer patients with abdominal cavity metastasis.Methods:A total of 80 gastric cancer patients with abdominal cavity metastasis were treated in the People's Hospital of Haian City in Jiangsu Province from January 2017 to December 2019 were selected. They were randomly divided into the control group and the observation group according to the number table method, 40 cases in each group. The control group was given FOLFOX (oxalipatin + calcium leucovorin + fluorouracil) chemotherapy combined with recombinant human endostatin, and the observation group was in combination of lentinan injection on the basis of the control group. The short-term efficacy, tumor markers before and after treatment, immune function, angiogenesis related factors levels and adverse reactions of the two groups were analyzed.Results:After treatment, the short-term effective rate in the observation group was higher than that in the control group [67.5% (27/40) vs. 47.5% (19/40), χ2 = 4.256, P < 0.05]. The level of tumor markers like tumor supplied group of factors (TSGF), carcino-embryonic antigen (CEA), and carbohydrate antigen 72-4 (CA72-4) of both groups after treatment was decreased compared with that before treatment; after treatment, the level of TSGF, CEA and CA72-4 in the observation group was lower than that in the control group [TSGF: (48.99±3.14) U/ml vs. (55.17±3.68) U/ml, t = -8.080, P < 0.01; CEA: (0.40±0.09) ng/ml vs. (0.47±0.10) ng/ml, t = -3.291, P = 0.002; CA72-4: (3.51±1.14) U/ml vs. (8.42±2.57) U/ml, t = -11.045, P < 0.01]. The proportion of CD3 +, CD4 +, and the ratio of CD4 +/CD8 + of both groups after treatment was decreased compared with that before treatment. The proportion of CD3 +, CD4 +, and the ratio of CD4 +/CD8 + in the observation group was higher than that in the control group after treatment [CD3 +: (38.53±5.12)% vs. (31.82±4.75)%, t = 6.076, P < 0.01; CD4 +: (25.36±4.39)% vs. (19.12±3.91)%, t = 6.713, P < 0.01; CD4 +/CD8 +: 1.05±0.24 vs. 0.83±0.19, t = 4.546, P < 0.01]. The level of angiogenesis-related factors like p53, vascular endothelial growth factor (VEGF), and transforming growth factor β 1 (TGF-β 1) of the two groups after treatment was decreased compared with that before treatment. The level of p53, VEGF, and TGF-β 1 in the observation group was lower than that in the control group after treatment [p53: (132.86±31.24) ng/L vs. (163.24±33.27) ng/L, t = -4.210, P < 0.01; VEGF: (425.23±36.79) ng/L vs. (673.57±63.28) ng/L, t = -21.458, P < 0.01; TGF-β 1: (35.87±4.03) ng/ml vs. (38.26±4.32) ng/ml, t = -2.559, P = 0.012]. The incidence of grade Ⅲ-Ⅳadverse reactions in the observation group was lower than that in the control group [47.5% (19/40) vs. 62.5% (25/40), χ2 = 6.142, P < 0.05]. Conclusion:Lentinan injection combined with recombinant human endostatin is safe and effective in treatment of gastric cancer patients with abdominal cavity metastasis, and it is worthy of clinical promotion.

Objective To investigate the indications and clinical efficacy of an exclusive right-thoracic approach in esophageal surgery.Methods The clinical data of 35 patients with esophageal disease who underwent an exclusive right-thoracic approach operation from June 2008 to June 2010 at the Affiliated Hospital of Qingdao University were retrospectively analyzed.Of the 35 patients,21 were with esophageal cancer,and their ages were above 70 years,the partial pressure of oxygen of arterial blood (PaO2),maximal voluntary ventilation and forced vital capacity of the first second were (70 ± 9) mm Hg (1 mm Hg =0.133 kPa),51％ ± 9％ and 57％ ± 11％,respectively.Fourteen patients were with benign esophageal disease or low grade malignancy,and their PaO2 maximal voluntary ventilation and forced vital capacity of the first second were (96 ± 13) mm Hg,83％ ± 11％ and 91％± 14％,respectively.Exclusive right-thoracic approach was selected for all the patients,and surgical procedure was selected according to the location of the lesions.Patients were followed up by out-patient examination or phone call till April 2012.Results All the operations were carried out successfully,21 patients with esophageal cancer underwent partial esophagus resection and stomach-esophagus intrathoracic anastomosis through a right-thoracic approach.Of the 14 patients with benign esophageal disease or low grade malignancy,2 patients were with esophageal leiomyoma,3 with esophageal stromal tumor and 1 with esophageal leiomyomatosis underwent partial esophagus resection + intrathoracic anastomosis ; 7 patients with esophageal leiomyoma and 1 with esophageal stromal tumor underwent tumor extirpation.The operation time and operative blood loss were (3.4 ± 1.8)hours and (160 ± 44)ml,respectively.The number of lymph node dissected of the 21 patients with esophageal tumor was 14 ± 5,including 1.1 ± 0.7 lymph nodes dissected near the left gastric artery.No anastomosis fistula and perioperative death were detected,and the duration of hospital stay was (10 ± 4)days.The postoperative PaO2,maximal voluntary ventilation and forced vital capacity of the first second were (66 ± 10)mm Hg,50％± 11％ and 51％ ± 13％ for patients with esophageal cancer,and (94 ± 13) mm Hg,80％ ± 13％ and 87％ ± 16％ for patients with benign esophageal disease or low grade malignancy.All the patients were followed up for 1-2 years,no eating obstruction was detected,and the postoperative 1-and 2-year survival rate were 82.9％(29/35) and 77.1％ (27/35),respectively.Of the 8 patients with esophageal cancer who died postoperatively,1 died of cardiovascular diseases and 7 died of tumor recurrence and metastasis.Conclusion Exclusive rightthoracic appraoch could be used for patients with benign esophageal disease,low-grade malignancy and old esophageal cancer patients with poor pulmonary function.

Objective To develop the method of analyzing α-radionuclides using large area grid ionization chamber.Methods Ultrasonic dispersion and vacuum drying system was used to prepare sample source,large standard thin source and plutonium plane source were used to optimize the working condition of spectrometer,and calibrate the instrument for analyzing α emitters.The certified reference materials (GBW04127) were used to verify the accuracy of the method.Results The non-linearity of calibration curve for standard thin sources of neptunium,plutonium and americium was less than 0.2％,and the resolution were 112,84 and 106 keV,respectively.The counting efficiency was 31.2％ for the large standard thin source.The values of specific activity measured in this way were in good agreement with those of the certified reference materials.232Th,238U,230Th,234U/226Ra,210Po,222Rn and 218Po were analyzed in a uranium mineral sample,and their specific radioactivity values were 5.3,3.8,35.6,21.4,27.0,19.6 and 11.1 Bq/g,respectively.Conclusions The method can be used to analyze α spectrum quickly in low-level radioactive environmental samples.

Objective To develop a rapid and reliable method for determination of 210Po using large-area grid ionization chamber α spectrometry.Methods Samples were digested using a microwave digestion system.After preparation of sample source,the concentration of 210Po in clam was detected by large-area grid ionization chamber (φ 25 cm).209Po tracer was used to obtain the recovery.Results Large-area grid ionization chamber could achieve better counting and α spectrum resolution when the optimized thickness was 250 μg/cm2.By spiking 209Po tracer in clam,the minimum detectable activity was 9.870 × 10 4 Bq and the recovery of 210Po was 98％.Conclusions Compared with the traditional method,the developed method can avoid separation process,using less quantity of sample (0.2-0.5 g dry) and simplify the measurement process.This method may be has broad application prospects.

Objective To evaluate the effect of oxidative injury induced by peroxide oxidase on Klotho expression in mouse renal tubular epithelial cells (TCMK-1) and to explore the possible pathway.Methods TCMK-1 cells were exposed to H2O2 of different concentrations.Reactive oxygen species (ROS) was examined byflow cytometrry.Cell viability was assessed by CCK-8.Cell apoptosis was evaluated by flow cytometry and Hoechst 33258 staining.The expression of Klotho,apoptosis-associated proteins and anti-oxidant enzymes were determined by Western blotting.Results Compared with control group,after H2O2 stimulating TCMK-1 cell,ROS was dramatically elevated (all P ＜ 0.05) and the expression of anti-oxidant enzymes,SOD2 and CAT went down (all P ＜ 0.05);the expression of Klotho was inhibited (all P ＜ 0.05);cell viability of TCMK-1 cells was decreased (all P ＜ 0.05) in a dose-dependent manner (0.3 to 0.9 mmol/L);cell apoptosis was significantly increased in TCMK-1 cells following the concentration of H2O2 (all P ＜ 0.05);Bax/Bcl-2 and the phosphororation of JNK and p38 were obviously elevated in TCMK-1 by H2O2 induction (all P ＜ 0.05).Conclusion Oxidative injuries induced by H2O2 significantly suppresses the expression of Klotho in TCMK-1 cells.And cell apoptosis was increased,p38 and JNK pathway was activated.

Objective To investigate the prevalence of glomerular microthrombosis in lupus nephritis (LN) and the significance of antibodies to anti-coagulation related factors and anti-phospholipid antibodies in glomerular microthrombosis (GMT).Methods Kidney biopsy specimens and plasma samples were obtained consecutively from 124 patients with LN. Kidney biopsy specimens were examined for the presence of glomerular microthrombi.Plasma samples from 25 LN patients with GMT (LN-GMT group) and 99 LN patients without GMT (LN-non-GMT group) were tested for lupus anticoagnlant (LA) and antibodies to cardiolipin (ACL),β2 glycoprotein I (β2GP I ),plasmin,thrombin,tissue plasminogen activator (t-PA) and Annexin A II.Results The prevalence of GMT in LN patients was about 20.2%.Compared to LN-non-GMT group,LN-GMT group had elevated SLE disease activity indices (SLEDAI),elevated activity and chronicity indices of kidney tissue injury,and elevated serum creatinine,blood urea nitrogen and proteinuria levels,and also had a higher frequency of hypertension (P＜0.01).The positive rates of LA,IgG class anti-β2GP I and anti-thrombin antibodies were higher in LN-GMT group than in LN-non-GMT group (P＜0.05).The positive rates of IgG class antibodies to ACL,plasmin,t-PA and Annexin A II in LN-GMT group were not statistically different from those in LN-non-GMT group (P＞0.05).No difference was found in the positive rate of any IgM class antibody between the two groups (P＞0.05).Conclusion This study has shown that GMT occurs approximately in 20.2% of the LN patients.Patients with GMT have more severe kidney tissue injury and more poor renal outcomes than patients without GMT.LA and antibodies to β2GP I and thrombin play a role in glomerular microthrombosis in lupus nephritis.

Rhinosinusitis is a popular disease in otorhinolaryngology.A guideline document,European position paper on rhinosinusitis and nasal polyps (EPOS) developed on the basis of evidencebased medicine was used in clinical teaching.Theoretical teaching was promoted by reading and understanding EPOS.Meanwhile,EPOS was used in clinical practices of preclinical ward round,case analysis and independent bed charge,which laid a solid foundation to help otorhinolaryngology postgraduates fully grasp the theoretical knowledge of rhinosinusitis and nasal polyps,improve clinical practice abilities and develop standardized philosophy of diagnosis and treatment finally.

Objective To evaluate the efficacy and safety of REXEEDTM series highflux dialyzer. Methods A randomized cross-over study of 3×3 Latin square was designed based on the surface area of dialyzer membrane (1.5 m2 and 2.1 m2). Seventy-two stable maintenance hemodialysis (MHD) patients from Shanghai Renji Hospital and Ruijin Hospital were enrolled in this study for 3 consecutive weeks. REXEEDTM-15AC, 15UC, 21AC, 21UC dialyzers were used as trial group and APS-15U,BIO-HX100 dialyzers were used as control group. The clearances of urea, creatinine, phosphorus and β2-microglobulin were calculated. Adverse event and adverse reactions were recorded. Results There were significantly higher urea and creatinine clearance in 1SAC and 15UC dialyzers as compared to APS-15U dialyzer [(222.07±18.74) mi/min, (220.23±26.26) ml/min vs (199.56±14.21) ml/min; (176.73±16.41) ml/min, (175.22±25.94) ml/min vs (165.42±14.68) ml/min, all P<0.05]. There were significantly higher urea, creatinine and β2-microglobulin clearance in 21AC and 21UC dialyzer as compared to BIO-HX100 dialyzer [(230.59±15.24) ml/min, (233.96±7.06) ml/min vs (203.43±36.66) ml/min; (183.50±25.90) ml/min, (181.05±23.94) ml/min vs (166.25±29.82) ml/min; (111.77±53.42) ml/min, (125.54±51.99) ml/min vs (42.39±4.81) ml/min; all P<0.05]. There was no significant difference of phosphorus clearance between REXEEDTM series dialyzers and control dialyzers. The efficiency of urea clearance and urea reduction ratio could achieve clinical targets in REXEEDTM series. Conclusion REXEEDTM series highflux dialyzers are effective and safe for clinical application.

Objective To understand the prevalence of group sex in men who have sex with men (MSM) and related factors in Taizhou,Zhejiang province.Methods From March 2013 to September 2015,a cross-sectional survey was conducted among MSM recruited from gay bars or bath houses in Taizhou by using questionnaire to collect the information about their sexual behavior and HIV test.Results A total of 1 435 MSM were recruited,179 of them (12.5％) were HIV infected,231 (16.1％) reported group sex during the past year.Compared with MSM without group sex,more MSM with group sex had more than ten male sexual partners (53.7％ vs.19.0％,x2=125.527,P＜ 0.01),had both male and female sexual partners (86.6％ vs.68.2％,x2=31.935,P＜0.01),used no condom at sex with female partners during the past year (28.1％ vs.19.8％,x2=6.540,P＜0.05).After adjusted for educational level and occupation,group sex was associated with age [≥ 50 years old vs.≤ 24 years old,adjusted odds ratio (aOR)=2.25,P=0.027],marriage with female (divorced or widowed vs.unmarried,aOR=0.29,P=0.001),census registering (local resident vs.non-local resident,aOR=1.56,P=0.023),number of male seuxal partners (≥21 vs.2-5,aOR=8.06,P＜0.001;11-20 vs.2-5,aOR=3.25,P＜0.001) and number of female seuxal partners (≥6 vs.0,aOR=2.63,P=0.005;2-5 vs.0,aOR=2.58,P=0.001;1 vs.0,aOR=2.01,P=0.010).Conclusion The prcvalcncc of group sex in MSM was high in Taizhou,and their poor condom use and complex sex behaviors would result in higher HIV infection rate and risk of transmission.

Objective To explore the clinical value of serum ferritin (SF),erythrocyte sedimentation rate (ESR) and erythrocyte average indexes [mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH),mean corpuscular hemoglobin concentration (MCHC)] in the prognosis evaluation of patients with small cell lung cancer (SCLC).Methods A total of 72 SCLC patients were enrolled in the Haian People's Hospital Affiliated to Nantong University from January 2013 to October 2016 (SCLC group),and 80 health controls were selected at the same time (control group).The levels of serum SF,ESR and erythrocyte average indexes in SCLC group and control group were detected,and their relationships with clinical features,prognosis and survival time were analyzed.Results The serum levels of SF,ESR,MCV,MCH and MCHC in SCLC patients were (309 ±59) μg/L,(16 ±4) mm/h,(104 ± 12) fl,(32 ±4) pg and (307 ±21) g/L,respectively.The serum levels of SF,ESR,MCV,MCH and MCHC in control group were (186 ±26) μg/L,(15 ±5)mm/h,(85 ± 7) fl,(30 ± 3) pg and (335 ± 25) g/L,respectively.Compared with the control group,the patients in SCLC group were significantly increased on the levels of SF (t =14.168,P ＜ 0.001) and MCV (t =6.143,P ＜ 0.001),and were significantly decreased on the level of MCHC (t =-4.220,P =0.003).There were no significant difference in the levels of ESR (t =1.931,P =0.102) and MCH (t =1.220,P =0.313) between the two groups.The serum levels of SF and MCV were significantly correlated with the stage of SCLC (t =-4.092,P =0.009;t =-4.985,P ＜ 0.001).Multivariate logistic regression analysis showed that high serum SF (OR =5.31,95％ CI:3.09-9.31,P ＜ 0.001) and MCV (OR =1.78,95％ CI:1.10-3.08,P =0.013) were independent risk factors of SCLC.Survival analysis showed that the survival time of the patients in the high SF group was significantly shorter than that in the low SF group (6 months vs.20 months;x2 =6.556,P =0.001).Conclusion Serum ESR,MCH and MCHC levels are not significantly correlated with SCLC,but serum SF and MCV levels are of important clinical significance in evaluating the prognosis of SCLC patients.