Objective To study the effect of laparoscopicassisted radical gastrectomy in advanced gastric cancer.Methods According to the inclusion criteria,164 patients with advanced gastriccancer who treated in the Cancer Institute and Hospital,Chinese Academy of Medical Sciences betweenJanuary and June of 2009 were enrolled into the study.Based on the operation methods,all cases were divided into the experimental group(laparoscopy group,n =79)and the control group(laparotomy group,n =85).Except for the laparoscopicassisted radical gastrectomy,patients received the same treatment in thethe experimental group and control group.Intraoperative indexes,postoperative pathological results and recovery,complications and 5year survival rate were observed and compared between groups.Results Therecovery time of patient's general condition in the experimental group was shorter than that of the controlgroup(P <0.05).The difference of serious postoperative complications rate between the two groups wassignificant(P <0.05).The difference of 5year survival rate between the two groups was not significant(P >0.05).Conclusion Laparoscopicassisted radical gastrectomy is safe and feasible in the treatmentof advanced gastric cancer.This technique could get equal treatment effect as laparotomy and it has obviousadvantage in postoperative recovery.

Objective To explore the effect of surface electromyographic biofeedback (SEMG-BFT) combined with electrical stimulation on the swallowing function of stroke survivors with dysphagia,and to evaluate the electromyographic activity of the submental muscles in swallowing various foods so as to provide a basis for future rehabilitation of such patients.Methods Sixty patients were randomly divided into a treatment group and a control group,each of 28.Both groups were given low-frequency electrical stimulation and conventional swallowing training.The treatment group was additionally provided with SEMG-BFT.Before the treatment as well as after 2 and 4 weeks of treatment,the swallowing function of both groups was evaluated using the Kubota drinking water test (KDWT) and a Gugging swallowing screen (GUSS).Surface electromyographs of the submental muscles were recorded during empty swallowing,swallowing 10 ml of dilute liquid and swallowing 10 ml of paste.Results After two and four weeks of treatment,the average KDWT and GUSS scores of both groups had improved significantly,but that of the treatment group was significantly higher than that of the control group at each time point.After 2 and 4 weeks of treatment,significant differences were found in swallowing duration and the average amplitude of the sEMGs compared with before the treatment in both groups.The difference between the groups was significant at each time point.Conclusions SEMG-BFT combined with electrical stimulation can significantly improve swallowing function.Paste food can be used safely in the early evaluation and treatment of swallowing dysfunction.

Objective:A new algorithm based on Hough transform (HT) was proposed to improve the accuracy and stability of the film image analysis of Automatic Quality Assurance (AQA) test, and to explore the influence of the resolution of film image on the test results.Methods:Nine pairs of films were obtained for AQA modules in this study. Firstly, the median filter was used to preprocess the grayed-out film image to remove noise interference. Then, a global threshold was utilized to binarize the image. The images were edge-detected and the film edge line was extracted by Hough transform. The film image was transformed to the correct position. Finally, the edge of the field shadow circle and the shadow circle of the tungsten ball were extracted by the edge detection method and Hough transform. The radial error was finally obtained by analyzing the concentricity.Results:There was no significant difference in the accuracy between the test results yielded by the HT method and the AQA software ( P>0.05). The difference in the standard deviation of the test results was statistically significant ( P=0.027), indicating that the algorithm increased the stability while ensuring the accuracy of film analysis. Increasing the resolution of film scanning failed to significantly improve the accuracy and stability of film analysis in both two methods. Conclusions:The algorithm used in this study can eliminate the human error caused by film scanning placement while ensuring the accuracy of film analysis, providing a more stable way for the AQA test of the CyberKnife system.

Objective To explore the role of viral infection in the development of drug eruption in patients with HIV infection, and to evaluate the efficacy of antiviral treatment. Methods This study enrolled 87 HIV-positive patients, including 11 with and 76 without drug eruption, all of whom received highly active antiretroviral therapy(HAART). Clinical data on, baseline CD4+ and CD8+ T cell counts and CD4/CD8 ratio in these subjects were retrospectively analyzed. Results The severity of drug eruption was mild in the 11 HIV-positive patients, with a mean latency period of (14.00 ± 8.10)(range, 8 - 34)days. Of the 11 patients with drug eruption, 7 had liver function impairment, which was not in accordance with the severity of skin lesions. Drug eruption was controlled in all the 11 patients after anti-anaphylactic treatment without withdrawal of antiviral drugs. Compared with 75 HIV-positive patients without drug eruption, the 11 HIV-positive patients with drug eruption showed significantly increased baseline CD4 + T cell counts (493.00 ± 245.68 (range, 42 - 810)/μl vs. 347.81 ± 167.00 (range, 11 - 814)/μl, t = 647.50, P < 0.05), but decreased proportion of patients with baseline CD4+ T cell counts below the lower limit of normal(3/11 vs. 48/75(64.00%), X2 = 3.95, P < 0.05). There were no significant differences between 10 patients with drug eruption and 69 patients without drug eruption in the baseline CD8+ T cell count(1472.30 ± 858.55/μl vs. 1356.59 ± 684.06/μl, P > 0.05), CD4/CD8 ratio(0.40 ± 0.27 vs. 0.29 ± 0.16, P > 0.05), or percentage of patients with a CD4/CD8 ratio below the lower limit of normal (9/10 vs. 68/69 (98.55%), P >0.05). Conclusions The latency period of drug eruption seems to be long in HIV-positive patients receiving HAART, and mild drug eruption can be complicated by liver function impairment in the patients. Relatively high CD4 + counts may be a risk factor for the development and aggravation of drug eruption in HIV-positive patients.

Objective To investigate the expression of Notch1,Notch3 and Hes1 in gastrointestinal stromal tumors(GIST) and their clinical significance.Methods Quantitative real-time polymerase chain-reaction(Q-PCR) and Western blot were applied to detect the mRNA and the expression of Notch1,Notch3 and Hes1 in 135 matched GIST specimens and adjacent tissues.Meanwhile,the expression of Notch1,Notch3 and Hes1 was detected by immunohistochemistry,and the relationship between their expression and clinicopathological factors in GIST patients was analyzed.In addition,a total of 40 wild type mice(WT) and Notch1 knockout mice(KO) was divided into WT group,KO group,WT+ GIST group and KO+GIST group,and the expression of Notch1,Notch3 and Hes1 in each group was detected.Results Compared with adjacent tissues,the mRNA andthe expression of Notch1,Notch3 and Hes1 were up-regulated in GIST tissues(P＜0.05).The positive rates of Notch1,Notch3 and Hes1 in the GIST specimens (59.26 ％,65.19 ％ and 62.22 ％) were higher than those in the adjacent tissues(17.780％,22.22 ％ and 17.78 ％),and the difference was statistically significant(P＜0.05).Statistical analysis showed that the expression of Notch1 was significantly correlated with the NIH grade of GIST(x2 =8.532,P=0.002);the expression of Notch3 was significantly related with tumor metastasis of GIST (x2 =7.532,P=0.003);the expression of Hes1 was significantly associated with the tumor size of GIST(x2 =6.781,P=0.012).The expression of Notch1,Notch3 and Hes1 was higher in WT+GIST group compared to the expression found in WT group(all P＜0.05).There were no significant differences in the expression of Notch1,Notch3 and Hes1 between WT+ GIST group and KO+GIST group.The expression of Notch1,Notch3 and Hes1 was lower in KO+ GIST group compared to the expression found in WT+GIST group(all P＜0.05).Conclusion The expression of Notch1,Notch3 and Hes1 related to Notch signaling pathway is elevated in GIST tissues,and the activation of Notch signaling pathway may play an important role in the occurrence and progression of GIST.

Objective:To compare and analyze the accuracy of the invasive glucose detecting device and the non-invasive glucose device(NeoGlu01)based on artificial intelligence(AI)algorithm in detecting peripheral blood glucose.Methods:A total of 96 diabetic voluntary patients were recruited from the community of Beijing district from December 2022 to March 2023.The Roche ACCU-CHECK? Guide invasive glucose device was used to detect the peripheral blood glucose of volunteers,and the NeoGlu 01 type of non-invasive glucose device was used to collect the signal of the finger,so as to obtain the blood glucose value that was calculated by AI algorithm at the same time.Pearson correlation analysis was adopted to analyze the detected blood glucose values of the two kinds of devices.Results:Both the peripheral blood glucose values of invasive glucose detecting device and the calculated AI values of NeoGlu01 type of non-invasive glucose device for 96 diabetic patients had favorable consistency with calibration value(R2=0.978,0.882,P<0.05),respectively.Both the detected values of peripheral blood glucose of invasive glucose detecting device and the calculated AI values of NeoGlu01 type of non-invasive glucose device were between 6.2 and 16.7 mmol/L for 96 diabetic patients,and the difference was no significant(P>0.05).Parkes error grid analysis,that referred to the values of peripheral blood glucose,indicated the two times of the results of the values of mean absolute relative difference(MARD)of total accuracy indicator of calculated AI value of non-invasive glucose device were respectively 11.05%and 11.44%,and both the accuracy rate and repeatability of that were favorable.Conclusion:The predictive blood glucose value of NeoGlu01 non-invasive blood glucose device has favorable consistency and accuracy with the detected value of invasive glucose detecting device in detecting peripheral blood glucose.

Objective To establish a method for the simultaneous determination of adenosine, chlorogenic acid, caffeic acid, baicalin and wogonin in Ganmaoning granules. Methods The UPLC-MS/MS method was adopted. The separation was performed on ZOBAX SB C18 (2.1 mm×150 mm, 5μm) column with mobile phase consisted of methanol-2 mmol/L ammonium acetate aqueous solution (isocratic elution) at the flow rate of 0.2 ml/min. The column temperature was set at 35℃, and the injection volume was 2μl. The electrospray ionization source (ESI) was used. Multiple reaction monitoring (MRM) mode was adopted, using positive and negative ions scanning. The ion source temperature was 300℃, the drying gas temperature was 400℃, the drying gas flow was 20 L/min, the atomizing gas pressure was 55 psi, and the capillary voltage was 4000 V.Results The linear ranges of adenosine, chlorogenic acid, caffeic acid, baicalin and wogonin in Ganmaoling granules were 0.20-12.80 ng (r=0.9996), 1.00-64.00 ng (r=0.9998), 0.40-25.60 ng (r=0.9996), 4.00-256.00 ng (r=0.9992), 0.20-12.8 ng (r=0.9991), which showed the linear relationship was good. The limits of detection were 0.02, 0.10, 0.04, 0.40, 0.02 ng, respectively. The limits of quantitation were 0.04, 0.20, 0.08, 0.80, 0.04 ng, separately. TheRSDs of precision, reproducibility and stability (24 h) tests were no more than 3.5％. The recovery rates were 99.3％-100.75％ (RSD=2.09％-3.17％).Conclusions The method established in this experiment is simple, rapid, sensitive and accurate. It can be used to simultaneously determine the contents of five components inGanmaoling granules, and can be used for quality control ofGanmaoninggranules.

Objective:To develop an UPLC-MS/MS method for the simultaneous determination of baicalin, berberine, glycyrrhizic acid and puerarin in Gegen-Huangqin-Huanglian Decoction. Methods:Isocratic elution was carried out with mobile phase consisting of acetonitrile - 4 mmol/L ammonium formate. The separation was performed on ACE Excel 3 C18 (2.1 mm × 100 mm, 3 μm), and the mass spectrometer was operated in the positive and negative ionization electrospray (ESI) mode using multiple monitoring (MRM) for analysis of four components. External standard method was used for fix quantity. The precursor to product ion transitions monitored for baicalin, berberine, glycyrrhizic acid and puerarin were m/z 447.0→271.0, 336.2→320.2, 821.4→350.9 and 415.2→294.9, respectively. Results:Baicalin, berberine, glycyrrhizic acid and puerarin were all analyzed exactly, the linear ranges were 0.002-0.080, 0.002-0.080, 0.001-0.040, 0.002-0.080 ng, respectively. The r were 0.998 3, 0.999 4, 0.997 9 and 0.999 5, respectively. The recoveries of four analytes ranged from 98.75% to 100.86% and the relative standard deviations were all below 0.74%. Conclusions:UPLC-MS/MS method is sensitive, accuate with rapid speed, which could be used for the determination of baicalin, berberine, glycyrrhizic acid and puerarin in Gegen-Huangqin-Huanglian Decoction.

Objective To evaluate the efficacy,safety and economics of romiplostim for treating primary immune thrombocytopenia(ITP)by rapid health technology assessment,and to provide an evidence-based basis for policy makers and clinical practice.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data and VIP databases and the official websites of health technology assessment agency were electronically searched to collect high-quality clinical evidence and pharmacoeconomics evaluation literature of romiplostim for the treatment of ITP from inception to January 18,2024.Two researchers independently screened the literature,extracted information,and accessed the quality of included the literature,the extracted results were categorized and evaluated.Results A total of 14 literature were included,in which 8 systematic reviews/Meta-analysis and 6 pharmacoeconomic studies.In terms of efficacy,treatment with romiplostim significantly elevated platelet response rate,sustained platelet response rate,and mean platelet count in patients with ITP compared with placebo(P＜0.05).Romiplostim did not show a significant advantage in elevating patients'platelet response rate and sustained platelet response rate compared with other agents used to treat ITP(P＞0.05).In terms of safety,the incidence of serious adverse events was statistically lower with romiplostim compared to placebo(P＜0.05),while no significant differences were seen in the incidence of adverse events,bleeding events and thrombotic events(P＞0.05).There were no significant differences in the incidence of adverse events,serious adverse events,bleeding events,or thrombotic events when comparing romiplostim to other drugs for the treatment of ITP(P＞0.05).From an economic standpoint,most studies considered eltrombopag to be more economic advantages than romiplostim.Conclusion Romiplostim has good efficacy and safety in the treatment of ITP,and no advantage was shown in terms of economy.

Objective:To explore the value of conventional magnetic resonance imaging (MRI), diffusion weighted imaging (DWI), diffusion kurtosis imaging (DKI) sequence and pathological examination in predicting the efficacy of neoadjuvant chemotherapy (NAC) in advanced breast cancer.Methods:The clinical data of 65 cases of advanced breast cancer with NAC confirmed by pathology in the Affiliated Hospital of Jining Medical University from March 2022 to May 2023 were retrospectively analyzed, including 20 cases in the pathological complete remission (pCR) group and 45 cases in the non pCR group; All patients underwent routine MRI, DWI, DKI examinations and pathological analysis. The clinical pathological data, routine MRI features, apparent diffusion coefficient (ADC) values, mean kurtosis coefficient (MK), and mean diffusion coefficient (MD) between the two groups were analyzed; We compared the differences in various parameters between two groups and plotted receiver operating characteristic (ROC) curves to compare their diagnostic efficacy of NAC in breast cancer.Results:There were significant differences in molecular typing, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (Her-2) and Ki-67 between pCR group and non pCR group (all P<0.05). In pCR group, Her-2 overexpression type and triple negative breast cancer (TNBC) type breast cancer were more common. ER and PR were mostly negative, Her-2 was mostly positive, and Ki 67 was mainly positive. The difference in tumor T2WI signal between the pCR group and the non pCR group was statistically significant ( P<0.05), with the pCR group showing mostly moderate/low T2WI signal. The ADC and MD values of the pCR group were lower than those of the non pCR group, while the MK value of the pCR group was higher than that of the non pCR group, and the differences were statistically significant (all P<0.001). The area under the ROC curve (AUC) for predicting the efficacy of NAC using a clinical pathological model was 0.829, which was higher than the AUC of molecular subtypes, ER, PR, Her-2, and Ki-67 ( Z=3.008, 2.697, 2.815, 2.131, 2.376, all P<0.05); The AUC of the DKI+ DWI predicting the efficacy of NAC was 0.934, which was higher than that of the DWI single sequence model, and the difference in type was statistically significant ( Z=2.396, P=0.017). The diagnostic efficacy of the DKI+ DWI model was higher than that of the single parameter ADC, MD, and MK, and the differences were statistically significant ( Z=2.396, 2.219, 2.161, all P<0.05); The AUC of the combined imaging and pathology model was 0.983, and its diagnostic efficacy was higher than that of the conventional MRI feature model, pathology model, DWI model, and DKI model, with statistically significant differences ( Z=5.877, 2.961, 3.240, 2.264, all P<0.05). Conclusions:The results of pathology, conventional MRI, DWI and DKI parameters of pCR and non pCR breast cancer patients are significantly different, and the combined model is better than the single model in predicting the efficacy of NAC.