Purpose:To study analgesia effect ,adverse reactions and life quality changes of transdermal fentanyl in patients with cancer pain.Methods:30 patients with moderate or severe cancer pain were treated by transdermal fentanyl .The pain intensity, quality of life and adverse reactions were observed before and after the treatment.Results:After using transdermal fentanyl ,all the patients obtained moderate to good remission.The excellent,marked and moderate rates were 43.33%,53.33% and 3.33% respectively. The adverse reactions included nausea, vomiting,constipation,dizziness and lethargy.The rate of the adverse reactions was less.The quality of life improved markedly. Conclusions:Transdermal fentanyl is a safe,effective and simple way to relieve cancer pain in patients with moderate or severe pain.It can improve the quality of life markedly.Its adverse reactions are mild.

Objective:To investigate the role of phosphatase PP2CB in the innate immunity against RNA virus and the underlying mechanism.Methods:PP2CB expression in macrophages was silenced with the specific siRNA.The mRNA and protein expression level of type Ⅰ interferon was detected by Q-PCR and ELISA respectively.The phosphorylation level of TBK1 and IRF3 was analyzed by Western blot.Results:RNA virus VSV infection led to the expression change of PP2CB.Overexpression of PP2CB dose-dependently inhibited the activation of IFN-β reporter gene.PP2CB silencing by PP2CB siRNA significantly promoted the production of type Ⅰ interferon triggered by RNA virus VSV or SeV,and inhibited the replication of VSV in macrophages.Furthermore,PP2CB bound TBK1 upon RNA virus infection.PP2CB silencing up-regulated the phosphorylation level of TBK1 and IRF3.Conclusion:Upon RNA virus VSV or SeV infection,phosphatase PP2CB binds TBK1 and inhibits its phosphorylation to negatively regulate the activation of the antiviral innate immune signal pathway,which consequently suppresses the production of type Ⅰ interferon triggered by RNA virus VSV or SeV.

Objective To evaluate the efficacy of MRI-detected extramural venous invasion (mrEMVI) in predicting tumor responses to preoperative chemoradiatiotherapy (pre-CRT) in patients with locally advanced rectal cancer (LARC).Methods The clinicopathological data,tumor response and mrEMVI information of 47 LARC from February 2013 to December 2014 were retrospectively collected.mrEMVI was given 0-4 score according to the degree,3-4 score were defined as mrEMVI positive;patients with mrEMVI positive were divided into three subgroups according to vascular size (large,middle and small).Association between different mrEMVI subgroup and tumor response was analyzed using Fisher exact test.Result 26 patients were mrEMVI positive.18 and 8 patients scored 3 and 4 for mrEMVI positive,respectively;16,6 and 4 patients were small,middle and larger vessels of mrEMVI positive,respectively.Patients with mrEMVI positive had less TRG 0-1 than mrEMVI negative (P =0.019).Scored 4 and larger vessel of mrEMVI positive had less TRG 0-1 than mrEMVI negative (P =0.038 and 0.017).Conclusions mrEMVI positive score 4 or larger vessel predict poor tumor response to pre-CRT in patients of locally advanced rectal cancer.

Objective To evaluate the clinical value of multiple bladder biopsies in the diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC) during transurethral resection of bladder tumor(TURBT).Methods The data of 408 NMIBC patients from January 2009 to December 2013 was analyzed retrospectively.There were 302 males and 106 females.The mean age of these 408 patients was 65 years old from 33 to 86 years.Bladder multipoint biopsies were performed in 216 patients (biopsy group),and were not performed in the other 192 patients (control group).The multipoint biopsies were taken from right and left bladder walls,anterior and posterior walls,dome,trigone,prostatic urethra and abnormal mucosa.There were 127 males and 89 females in the biopsy group,with a mean age of 64 years old (from 18 to 87 years).In the control group,118 males and 74 females aged between 15 and 92 years have an average age of 66 years old.There was no statistically significant difference in regard to gender and age between the two groups.The positive rate of biopsy and whether the diagnosis and treatment plan changed in the study group were recorded and the recurrence and progression rates were compared between study and control groups.Results Of these 216 multiple mucosa biopsies,the total abnormal detection rate was 48.1％ (104/216).There were urothelial carcinoma in 12.5％ (39/216),carcinoma in situ in 5.6％ (12/216),dysplasia in 9.7％ (21/216),cystitis in 20.4％.The final diagnosis were changed in fifteen patients (6.9％) due to the biopsy results,and 38 patients(17.6％) treatment plans were changed.The 1-,3-,and 5-year recurrence-free survival rates (RFS) of biopsy group and control groups were 96.3％ vs.85.4％(x2 =14.955,P=0.000),85.2％ vs.69.8％ (x2 =13.183,P =0.000) and 69.9％ vs.64.1％ (x2 =1.574,P =0.245);progression-free survival(PFS) were 99.1％ vs.96.3％ (x2 =8.253,P =0.006),94.0％ vs.87.0％ (x2 =5.901,P=0.017) and90.3％ vs.85.4％ (x2 =2.273,P=0.169).The 1-and 3-year RFS and PFS of biopsy group were higher than control group.There was no significant difference in the 5-year RFS and PFS between the two groups.Conclusions Multiple bladder biopsies could be helpful for pathological diagnosis and the post-TUR treatment of NMIBC.Furthermore,it may reduce the early recurrence and progression rates of NMIBC,but have no effect on long-term prognosis.

Objective To prepare an influenza A(H1N1) split-virus vaccine and observe its safe-ty and effectiveness. Methods According to the process for preparing seasonal flu split-virus vaccine two batches of vaccine were prepared with the flu A (H1N1) vaccine virus strain recommended by WHO. The pilot products were tested against the requirements of flu split-virus vaccine. Results The quality of the pi-lot vaccine has been tested by National Control Laboratory and conformed to the requirements. Nine hundred and sixty volunteers received one dose of vaccine containing either 15 μg or 30 μg of hemagglutinin. The re-suits indicated the both seroconversion rate and protection rate were higher the 70%. The GMT of HIAb of the volunteers who received 1 dose of 15 μg increased significantly by 15, 39, 37 and 25 times compared to those before vaccination in the age groups of 3-11, 12-17, 18-59 and ≥60, respectively. And 26, 72, 68 and 36 times rise were found in the postvaccinated volunteers of 30 μg group. The total adverse reaction rates of 15 μg and 30 μg dose group were 29.38% and 43.75%, respectively. The grade 2 adverse reaction rates of 15 μg and 30 μg dose group were 6.25% and 15.42%, and the grade 3 adverse reaction rates of 15 μg and 30 μg dose group were 0.83% and 1.46%, respectively. No serious adverse reactions were found. Conclusion The influenza A (H1N1) split-virus vaccine prepared according to the requirements of season-al flu vaccine is safe and effective.

Objective:To explore the safety and efficacy of renal arterial hypothermia perfusion in robot-assisted laparoscopic partial nephrectomy.Methods:The data of 11 patients with complex renal tumors admitted to our hospital from March 2020 to December 2021 were retrospectively analyzed. There were 7 males and 4 females. The patients’age was (64.64±13.56) years old.The median R. E.N.A.L. score was 8 (7, 9) points. Preoperative glomerular filtration rate (GFR) was (64.40±25.52) ml/min. All patients had a renal artery cold solution perfusion robot-assisted laparoscopic partial nephrectomy. 4℃ sodium lactate Ringer's solution was injected into the affected kidney by the catheter, which could provide the kidney a hypothermic state during the operation and protected the renal function during the long period of warm ischemia. The intraoperative data and postoperative complications were recorded. The data of postoperative renal function, routine urine test, urinary CT, preoperative and postoperative glomerular filtration rate (GFR) were analyzed.Results:The renal artery blocking time was (34.09±2.84) min during the surgery. The patients’ body temperature was (36.10±0.44) ℃. The surgical duration was (126.73±47.08) min. The intraoperative bleeding was (81.82±53.07) ml. There were no complications, such as urinary leakage, low body temperature, fever, etc. There was no significant difference between the 3-months postoperative GFR (59.06±25.67) ml/min and preoperative GFR ( P=0.636). Conclusions:For patients with complex renal tumors, renal arterial cold solution perfusion in robot-assisted laparoscopic partial nephrectomy can help obtain longer operative duration during hot ischemia, preserve renal function, and it provide a safe and feasible surgical method for patients.

Purpose/Significance To apply the 5G ward round robot platform in primary hospitals,so as to effectively improve the treatment capability and management service level of patients with critical and severe diseases.Method/Process Based on technologies such as 5 G,internet of things(IoT)and robotics,the researchers build and deploy a 5 G ward round robot platform and collaborate with domestic experts to provide mobile ward round,remote consultation,intensive care,health education and other services for patients.Re-sult/Conclusion Real time sharing of patient clinical data and efficient collaboration in the diagnosis and treatment process can be a-chieved,multi-mode,accurate and standardized remote ward round and treatment guidance can be carried out according to patients'conditions.

Objective To explore the effectiveness of da Vinci Robot Xi system-assisted single-incision laparoscopic surgery for treating benign ovarian lesions in children and adolescents.Methods From June 2020 to March 2023,13 cases of benign ovarian lesions were operated by using a specially designed 4-channel single-incision laparoscopic device assisted by the da Vinci Robot Xi system.The docking between the da Vinci Robot and the patient was completed,and the affected ovaries were cut open with a non-powered scissors to expose the tumor tissue.The tumor tissue was removed as completely as possible along the edge of the tumor,and an absorbable suture was used to seal the wound followed by restoring the umbilical structure.Results All the 13 cases underwent ovarian benign lesion resection through a single incision in the umbilical region,without conversion to open surgery.The surgical time was 81-246 min,with an average of 161.4 min.The intraoperative bleeding volume was 5-50 ml,with an average of 21.2 ml.During the operation,2 cases of ovarian torsion and 3 cases of ovarian benign lesion rupture(with postoperative drainage tube placement)were found.Postoperative pathological findings showed 9 cases of mature teratoma,2 cases of serous cystadenoma,and 2 cases of simple cyst.The postoperative hospitalization time was 2-7 d,with an average of 4.2 d.There was 1 case of postoperative incision infection who was cured after antibiotic treatment.The follow-up period was 6-36 months,with an average of 21.1 months.No tumor recurrence or complications occurred,and all the patients had hidden scars on the umbilical incision.The patients and their families were satisfied with the postoperative appearance.Conclusion The application of da Vinci Robot Xi system-assisted single-incision laparoscopic surgery in the treatment of benign ovarian lesions in children and adolescents is safe and feasible,which can be considered as an option for treating such conditions.

OBJECTIVETo summarize the application of protective terminal ileostomy in laparoscopic total mesorectal excision for rectal cancer patients, and explore the risk factors associated with postoperative complications and timing of stoma closure.

METHODSClinical data of 77 patients with middle or low rectal cancer undergoing laparoscopic total mesorectal excision (TME) with preventive terminal ileostomy in our department from January 2007 to December 2013 were retrospectively analyzed. Independent risk factors associated to postoperative complications of terminal ileostomy were examined by logistic regression and timing of stoma closure was investigated.

RESULTThe total postoperative complication morbidity was 57.1% (44/77). Electrolyte disturbance was found in 39 cases (50.6%, 39/77), including 1 case of hypovolemic syncope. Parastomal hernia occurred in 9 cases (11.7%, 9/77). Peristomal dermatitis and subcutaneous abscess was observed in 1 case (1.3%, 1/77). The result of the single factor analysis of the water electrolyte disturbance after operation, the risk factors of P<0.2 were new adjuvant chemotherapy (P=0.094), tumor antigen (P=0.086) and TNM staging (P=0.026); Postoperative parastomal hernia of the single factor analysis results, the risk factors of P<0.2 included uses of antidiabetic drugs (P=0.172), ASA anesthesia (P=0.168) grading and TNM stage(P=0.161); But multivariate analysis revealed no risk factors associated with the above complications (all P>0.05). Sixty-five patients underwent stoma closure during follow-up, including 2 cases (3.1%) within 90 days, 20 cases (30.8%) from 90 to 180 days, and 43 cases (66.2%) more than 180 days.

CONCLUSIONSNo risk factors were found to be associated with main postoperative complications of protective terminal ileostomy after laparoscopic TME for rectal cancer patients, such as electrolytes imbalance and parastomal hernia. The timing of stoma closure should be longer than 180 days.

Biopsy ; Chemotherapy, Adjuvant ; Factor Analysis, Statistical ; Humans ; Ileostomy ; Laparoscopy ; Logistic Models ; Neoplasm Staging ; Postoperative Complications ; Rectal Neoplasms ; Retrospective Studies ; Risk Factors

OBJECTIVE: To determine whether contrast-enhanced harmonic ultrasonography can be used to predict the aggressiveness of prostate cancer. MATERIALS AND METHODS: Contrast-enhanced harmonic ultrasonography was performed in 103 patients suspected of prostate cancer before biopsy. Time intensity curves were reconstructed for systematic biopsy sites and sonographic abnormalities. The characteristics of the curves were described using hemodynamic indices including arrival time (AT), time-to-peak (TTP), and peak intensity (PI). The differences of hemodynamic indices between high-grade and low-grade cancer were analyzed and the correlations between the hemodynamic indices and biopsy Gleason score were studied. RESULTS: Prostate cancer was detected in 41 of 103 patients and there were significant differences in the hemodynamic indices between the biopsy sites of the non-malignant patients and prostate cancer lesions (p < 0.05). The prostate biopsies revealed 154 prostate cancer lesions, including 31 low-grade lesions and 123 high-grade lesions. The hemodynamic indices AT and TTP of high-grade tumors were significantly shorter than those of low-grade tumors (p = 0.001, 0.002). In addition, high-grade peripheral zone (PZ) tumors had higher PI than low-grade PZ tumors (p = 0.009). The PZ prostate cancer Gleason score correlated with PI, AT and TTP, with Spearman correlation coefficients of 0.223, -0.335, and -0.351, respectively (p = 0.013, < 0.001 and < 0.001). CONCLUSION: Contrast-enhanced ultrasound measurements of hemodynamic indices correlate with the prostate cancer Gleason score.
Aged ; Aged, 80 and over ; Biopsy, Needle ; *Contrast Media ; Hemodynamics ; Humans ; Male ; Middle Aged ; Phospholipids/*diagnostic use ; Prostate/pathology ; Prostatic Neoplasms/blood supply/diagnosis/*ultrasonography ; Sulfur Hexafluoride/*diagnostic use ; Ultrasonography, Doppler ; Ultrasonography, Interventional