Objective To explore the efficacy of intraductal chilled saline perfusion (ICSP) to reduce the thermal bile duct injury during the treatment of radiofrequency ablation (RFA) associating with occlusion of hepatic blood supply in rabbits.Methods 16 healthy New Zealand white rabbits were divided into 2 groups.Rabbits of the ICSP group were placed tubes in the common bile duct after laparotomy,and ICSP was performed during the RFA procedure accompanied with hepatic blood occlusion.While for rabbits of the non-ICSP group,hepatic blood occlusion and RFA were performed without ICSP.RFA electrodes were placed about 5 mm away from the hilus hepatis approximately.Contrast-enhanced ultrasonography (CEUS) was administrated to evaluate the sizes of the ablative zones after the procedure.On post-procedure 6 week,ultrasonography was prerformed to evaluate the changes of the biliary structure,and liver specimens of rabbits wcrc obtained for histopathologic observation of main bile ducts.Results Post-procedure CEUS examination showed that there was no significant difference in the size of the ablative zone between the groups (P ＞0.05).On post-procedure 6 week,rabbits of the ICSP group appeared with biliary dilatation more frequently by ultrasonography (P ＜0.05),and a higher degree of the injury of main bile duct by histopathologic observation (P ＜0.05).Conclusions In treatment of RFA accompanied with hepatic blood occlusion,RFA-induced bile duct injury may be decreased significantly with ICSP.

Objective To retrospectively analyze the treatment results and prognostic factors in patients with primary bone lymphomas (PBL).Methods Thirty-one patients with PBL treated between April 1994 and May 2009 at Sun Yat-sen University Cancer Center were analyzed.All patients were diagnosed by pathology.Twenty-two patients had stage Ⅰ E, 4 patients had stage Ⅱ E and 5 patients had stage ⅣE diseases.One patient was treated with surgical resection alone, 1 patient with radiotherapy (RT) alone, 2 patients with chemotherapy (CT) alone and 4 patients with resection followed by chemotherapy.The remaining 23 patients received CT combined with RT.The median radiation dose was 50 Gy.Results The median follow-up time was 45.2 months.The follow-up rate was 83.9%.Nine patients had a follow-up time of 10 years.The 5-year and 10-year overall survival rates were 92% and 92%, respectively.The 5-year and 10-year disease-free survival rates were 79% and 70%, respectively.In the group who received non-combined chemoradiotherapy, the complete response rate was 50%, the incidence of progression or recurrence was 2/8 and the median recurrence time was 6.8 months.In the group who received combined chemoradiotherapy, the complete response rate was 65%, the incidence of progression or recurrence was 13% and the median recurrence time was 39.1 months.In univariate analyses, favorable prognostic factors for survival included age≤50 years (χ2=5.32,P=0.021) and ECOG PS score 0-1(χ2=5.48,P=0.019).Favorable prognostic factors for DFS included IPI score≤1(χ2=7.81,P=0.005) and ECOG PS score 0-1(χ2=18.70,P=0.000).Conclusions Treatment results of patients with PBL can be generally well.CT combined with RT appears to be the treatment of choice.RT dose ≥40 Gy is safe and feasible.Younger age and better performance status are associated with a better outcome.

Objective To learn the current status of family doctor service at pilot communities in Guangzhou, and discover existing problems and influencing factors by investigating the residents who have contracted such service , those have not and the family doctors . Methods This study chose typical community health centers of six communities in Guangzhou in January 2016 .In random sampling , residents who visited doctors during the survey and all the family doctors were surveyed .EpiData was used to doubly inputdata,withSPSS20.0forstatisticalanalysis.Results 66.0％ofthoseresidentswhohavenot contracted the service are willing to contract a family doctor .According to the binary logistic regression analysis after eliminating the interference factors , there are two factors affecting their willingness:gender and whether needing a family doctor for themselves and their family for health management .According to the binary logistic regression analysis after eliminating the interference factors , the influencing factors of renewing contract are overall satisfaction and necessity for signing family doctors .Conclusions The smooth development of the family doctor service is faced with many bottlenecks , while improving willingness to contract and renew contract to family doctors are the cornerstone for sustainability of the family doctor system.

Objective To observe the glymphatic system functional changes of bilateral cerebral hemispheres in early-stage Parkinson disease(PD)patients complicated with unilateral limb motor symptoms.Methods A total of 52 early-stage PD patients complicated with unilateral limb motor symptoms were prospectively enrolled,including 21 cases of left-onset PD(LPD group),31 cases of right-onset PD(RPD group).Meanwhile,28 healthy individuals were recruited as healthy controls(HC group).Clinical data and indices of diffusion tensor imaging analysis along the perivascular space(DTI-ALPS)were compared among 3 groups and between each 2 groups.The correlations of DTI-ALPS indices and clinical scales were analyzed.Results Significant difference of Hamilton depression scale(HAMD)score was found among 3 groups(P＜0.05).HAMD score of LPD group and RPD group were higher than that of HC group(both P＜0.017).There were significant differences of left and right cerebral hemispheres DTI-ALPS(DTI-ALPS_L,DTI-ALPS_R)indices among 3 groups(both P＜0.05).DTI_ALPS_R in LPD group was lower than that in HC group(P＜0.017),and DTI_ALPS_L in RPD group was lower than that in HC group(P＜0.017).No obvious correlation of bilateral cerebral hemisphere DTI-ALPS indices with clinical scales was detected in PD patients(all P＞0.05).Conclusion Like that of motor symptoms,glymphatic system dysfunction of PD patients had characteristics of laterality,manifested as DTI_ALPS_R decreased in LPD patients while DTI_ALPS_L decreased in RPD patients.

Objective To analyze the clinicopathological data of patients with papillary thyroid microcarcinoma(PTMC)and papillary thyroid non-microcarcinoma(non-PTMC)who received 131I therapy retrospectively,and compare the therapeutic response of the two groups of patients,so as to guide 131I therapy decisions for PTMC patients.Methods A total of 1 118 patients with papillary thyroid carcinoma(PTC)underwent 131I therapy in the Department of Nuclear Medicine,Tianjin Medical University General Hospital from January 2015 to December 2020 were enrolled.Chi-square test and Mann-Whitney U test were used to compare the differences of clinicopathological features and 131I therapy,therapeutic response between two groups.The incomplete response(IR)rate curves of the two groups were plotted by Kaplan-Meier analysis.Results The proportion of patients with multifocal,involvement of bilateral thyroid lobes in PTMC group were higher than those in non-PTMC group,and the proportion of patients with extra-thyroid extension,T4,N1b,stimulated thyroglobulin(sTg)>10 μg/L,and high risk stratified were lower than those in non-PTMC group(P<0.05).Most patients in PTMC group received remnant ablation for the first time,while more patients in non-PTMC group received adjuvant therapy and therapy for known disease(P<0.05).There was no statistically significant difference in 131I therapeutic response,the rates of excellent response(ER)and IR in two groups,and the differences in curves of IR rate between the two groups were also no statistically significance(P>0.05).Conclusions PTMC has a certain degree of invasiveness.As long as the patients were comprehensively evaluated and the standard 131I therapy was adopted,the treatment outcomes of patients with PTMC and non-PTMC were roughly the same.Therefore,the clinical value of the definition of PTMC is extremely limited in the formulation of 131I therapeutic dose regimens.

Objective:To summarize the best evidence for spasticity management in spinal cord injury patients, so as to provide references for clinical practice.Methods:PubMed, Embase, CLINICAL, BMJ Best Clinical Practice website, JBI Evidence-based Health Care Center database, National Institute for Health and Clinical Excellence, Ontario Guidelines Network, US National Guidelines Network, Scottish Interhospital Guidelines Network, UpToDate, Cochrane Library, CNKI, Wanfang Database, Medlive, China Biology Medicine disc and professional association websites were syatematically searched for clinical decisions, guidelines, evidence summary, systematic reviews and expert consensus or opinions on spasm management. The quality of the included studies was evaluated and the evidence content was extracted. The search period was from the establishment of the databases to February 28, 2023.Results:A total of 15 articles were included, including 2 clinical decision-making articles, 1 guideline, 3 expert consensus or opinions articles and 9 systematic evaluations. A total of 18 pieces of evidence were summarized from 4 aspects, such as regular evaluation, intervention measures, intervention principles, and effectiveness evaluation of patients with spinal cord injury.Conclusions:This study summarizes the best evidence for spasticity management in patients with spinal cord injury and provides an evidence-based basis for clinical work. It is recommended that when applying the evidence, an individualized spasticity treatment plan should be developed according to the needs of the patient and the actual clinical situation.

Objective To investigate the effects of hydrogen (H2) on myocardium injury post-cardiac arrest (CA) in rabbits.Methods Sixty New Zealand rabbits were randomly divided into H2 treatment group (n = 30) and control group (n = 30) by random number table. The rabbit CA model was established by means of electrical stimulation of external membrane, both groups were mechanically ventilated. Cardiopulmonary resuscitation (CPR) was performed after 6 minutes of nonintervention, and stopped after restoration of spontaneous circulation (ROSC). Inhalation of 2％ H2 gas was conferred to rabbits immediately at the end of CA modeling for 72 hours in H2 treatment group. Air was given to rabbits in control group instead. The survival rate of rabbits was analyzed. Heart rate, ventricular premature beat frequency, and the levels of blood samples cardiac troponin I (cTnI), left ventricular ejection fraction (LVEF), B-type natriuretic peptide (BNP), and blood lactic acid (Lac) were collected before CA and after ROSC in all rabbits. Rabbits were sacrificed and microstructure injury was observed by electric microscope after ROSC 72 hours.Results There were 28 animals ROSC in both groups; the survival number in H2 treatment group was higher than that in control group at 72 hours after ROSC (number: 15 vs. 7,χ2 = 4.791,P = 0.029). In the early stage of ROSC, the heart rate of two groups slowed down, the number of premature ventricular increased, and then gradually recovered; the heart rate in H2 treatment group was returning to normal more quickly than that in control group at 48 hours after ROSC (bpm: 319±63 vs. 362±40,P < 0.05); the ventricular premature beat frequency was lower than that in control group at 72 hours after ROSC (times per minutes: 9.1±4.3 vs. 15.0±8.0,P < 0.05). The animals of two groups had different degrees of myocardial damage and cardiac insufficiency after ROSC, and restored with the extension of time. Compared with control group, the level of BNP in H2 treatment group was significant decreased at 24 hours after ROSC (ng/L: 385±98 vs. 488±174,P < 0.05), the levels of cTnI and Lac were significant decreased at 48 hours after ROSC [cTnI (μg/L:1.83±0.68 vs. 2.83±0.98, Lac (mmol/L): 5.5±1.6 vs. 7.9±2.6, bothP < 0.01], the LVEF was slightly higher than that at 72 hours after ROSC (0.690±0.040 vs. 0.650±0.041,P = 0.051). Compared with control group, less damage to myocardial ultra structure was found in H2 treatment group at 72 hours after ROSC.Conclusion Inhalation of H2 alleviates cardiac dysfunction and myocardial injury after CPR.

Objective:To investigate the prognostic effect of polymorphnuclear neutrophil (PMN) in cervical cancer. Methods:Patients (n=92) who underwent curative surgery for the treatment of stage Ib and IIa cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) were assessed to determine their tumor-infiltrating CD66b-positive neutrophils through immuno-histochemistry. Assessment results were then analyzed to identify their correlation with recurrence-free survival (RFS) as an end point. Kaplan-Meier method was used for survival curve analysis, and a Cox proportional hazard model was utilized for univariate and multi-variate analyses. Results:The RFS of the group with a density of CD66b-positive neutrophils above the median in cervical cancer tis-sues was significantly shorter than that of the group with a density of CD66b-positive neutrophils below the median (P=0.001). Univari-ate and multivariate analyses revealed adenocarcinoma (HR=3.020;95%CI=1.340-6.805;P=0.008), lymph node metastasis (HR=2.450;95%CI=1.065-5.637;P=0.035), and high neutrophil density (HR=2.866;95%CI=1.274-46.447;P=0.011) as independent prognostic fac-tors of short RFS. Conclusion:The increasing number of tumor-infiltrating neutrophils in cervical cancer tissues was correlated with short RFS of patients with cervical cancer.

Objective To evaluate the effect of continuous transversus abdominis plane (TAP) block on postoperative systemic inflammatory responses of patients undergoing laparoscopic radical surgery for colorectal cancer.Methods Ninety-eight patients,aged 45-64 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,weighing 50-75 kg,scheduled for elective laparoscopic radical surgery for colorectal cancer under general anesthesia,were divided into continuous patient-controlled epidural analgesia (PCEA) group (group PCEA) and continuous TAP block group (group TAPB) using a random number table,with 49 patients in each group.An epidural catheter was placed at L1,2 interspace,a test dose of 3 ml of 2％ lidocaine was given,and morphine 2 mg (in 10 ml of normal saline) was injected into the epidural space at the end of surgery in group PCEA.PCEA solution contained 0.15％ ropivacaine and sufentanil 2 μg/ml (diluted to 300 ml in normal saline).PCA pump was set up with a 2 ml bolus dose,a 20 min lockout interval and background infusion at a rate of 4 ml/h.Catheterization of bilateral transversus abdominis plane was accomplished under ultrasound guidance,and 0.3％ ropivacaine 20 ml was injected in group TAPB.TAP block solution contained 0.15％ ropivacaine (diluted to 300 ml in normal saline).PCA pump was set up with a 6 ml bolus dose,a 30 min lockout interval and background infusion at a rate of 6 ml/h.Analgesia lasted until 48 h after surgery,and visual analogue scale score was maintained less than or equal to 3 in both groups.Parecoxib sodium 40 mg was intravenously injected as a rescue analgesic when visual analogue scale score was more than 3.Blood samples were collected from the right internal jugular vein at 24 h before operation (T0) and 48 h after operation (T1) for determination of the expression of CXCL8 mRNA in serum (by real-time polymerase chain reaction) and expression of CXCL8 and STAT3 in serum (by Western blot).The development of requirement for rescue analgesia,sensory motor dysfunction of lower extremities and nausea and vomiting after surgery was recorded.Results Compared with the baseline at T0,the expression of serum CXCL8 mRNA,CXCL8 and STAT3 was significantly up-regulated at T1 in the two groups (P＜ 0.05).Compared with group PCEA,the expression of serum CXCL8 mRNA and STAT3 was significantly down-regulated at T1,the incidence of sensory motor dysfunction of lower extremities was decreased (P＜0.05),and no significant change was found in the expression of serum CXCL8,requirement for rescue analgesia or incidence of nausea and vomiting in group TAPB (P＞0.05).Conclusion Continuous TAP block can reduce postoperative systemic inflammatory responses of patients undergoing laparoscopic radical surgery for colorectal cancer.

Objective To systematically evaluate the adult intraoperatively acquired pressure injury risk prediction model.Methods Related study on IAPI risk prediction model in Chinese and English databases such as CBM,CNKI,PubMed and Web of Science were searched.The language is limited to Chinese and English,and the search time is until November 4,2022.Two researchers independently screened the literature and extracted the data,and applied the bias risk assessment tool of prediction model research to analyze the bias risk and applicability of the included literature.Results 13 articles were included,including 17 models(operation time,age,diabetes,BMI and serum albumin are the most commonly used predictors).Among the 17 models,the area under the curve of 14 models was 0.616 to 0.984,and the other study did not report the AUC results.Among the 13 studies,10 had good applicability,while the remaining 3 had unclear applicability.13 studies have a high risk of bias,mainly because the included studies are retrospective studies,the predictive factors are screened based on univariate analysis,and the predictive outcomes are not defined by guidelines or standardization.Conclusions The existing IAPI risk prediction model for adults has good applicability,but the risk of bias is high,and the construction is not perfect.It is necessary to pay attention to the effectiveness of different risk assessment methods in the later construction,so as to get a better and more accurate risk prediction model and provide some reference and basis for formulating relevant prevention strategies.