Objective To investigate the protective effect of electrical stimulation-induced auditory brainstem response(EABR)monitoring on the cochlear nerve pathway during acoustic neuroma surgery.Methods The data of 36 patients who underwent acoustic neuroma surgery were studied,all surgeries were performed using the middle fossa approach.Among them,18 cases were monitored intraoperatively using EABR monitoring 4 times as the mo-nitoring group,while the other 18 cases underwent surgery without monitoring as the control group.The monito-ring group,preoperatively,there were 7 ears classified as grade A,6 ears as grade B,and 5 ears as grade C.The preoperative pure tone average thresholds(0.5,1.0,2.0,4.0 kHz)were 37.60±16.95 dB HL,and the maximum tumor diameter was 13.76±4.37 mm.The control group,preoperatively,there were 4 ears classified as grade A,7 ears as grade B,and 7 ears as grade C.The preoperative pure tone average was 46.80±22.64 dB HL,and the max-imum tumor diameter was 13.74±4.26 mm.Results In the monitoring group,except for the first monitoring,the V-wave evoked rate was 72.22％(13/18),and for the remaining three times,it was 100.00％(18/18).The mini-mum current stimulation intensity that could evoke the V-wave was 0.5 mA,and the V-wave latency was 3.97±0.17 ms.Follow-up was conducted for both groups of patients within 1 to 3 months postoperatively.In the monito-ring group,there were 7 ears classified as grade A,4 ears as grade B,4 ears as grade C,and 3 ears as grade D.Among them,3 patients experienced hearing loss after surgery,and the postoperative pure tone average was 52.20±38.35 dB HL.In the control group,there was 1 ear classified as grade A,1 ear as grade B,6 ears as grade C,and 10 ears as grade D.Among them,10 patients experienced hearing loss after surgery,and the postoperative pure tone average was 90.90±37.28 dB HL.Conclusion EABR monitoring during the resection of acoustic neuroma not only has positive significance for improving the hearing protection rate of acoustic neuroma surgery,but also assists the surgeons in identifying the cochlear nerve during surgery.The integrity of the auditory nerve pathway is protec-ted to the greatest extent for possible cochlear implanting.

Objective To investigate the protective effect of electrical stimulation-induced auditory brainstem response(EABR)monitoring on the cochlear nerve pathway during acoustic neuroma surgery.Methods The data of 36 patients who underwent acoustic neuroma surgery were studied,all surgeries were performed using the middle fossa approach.Among them,18 cases were monitored intraoperatively using EABR monitoring 4 times as the mo-nitoring group,while the other 18 cases underwent surgery without monitoring as the control group.The monito-ring group,preoperatively,there were 7 ears classified as grade A,6 ears as grade B,and 5 ears as grade C.The preoperative pure tone average thresholds(0.5,1.0,2.0,4.0 kHz)were 37.60±16.95 dB HL,and the maximum tumor diameter was 13.76±4.37 mm.The control group,preoperatively,there were 4 ears classified as grade A,7 ears as grade B,and 7 ears as grade C.The preoperative pure tone average was 46.80±22.64 dB HL,and the max-imum tumor diameter was 13.74±4.26 mm.Results In the monitoring group,except for the first monitoring,the V-wave evoked rate was 72.22％(13/18),and for the remaining three times,it was 100.00％(18/18).The mini-mum current stimulation intensity that could evoke the V-wave was 0.5 mA,and the V-wave latency was 3.97±0.17 ms.Follow-up was conducted for both groups of patients within 1 to 3 months postoperatively.In the monito-ring group,there were 7 ears classified as grade A,4 ears as grade B,4 ears as grade C,and 3 ears as grade D.Among them,3 patients experienced hearing loss after surgery,and the postoperative pure tone average was 52.20±38.35 dB HL.In the control group,there was 1 ear classified as grade A,1 ear as grade B,6 ears as grade C,and 10 ears as grade D.Among them,10 patients experienced hearing loss after surgery,and the postoperative pure tone average was 90.90±37.28 dB HL.Conclusion EABR monitoring during the resection of acoustic neuroma not only has positive significance for improving the hearing protection rate of acoustic neuroma surgery,but also assists the surgeons in identifying the cochlear nerve during surgery.The integrity of the auditory nerve pathway is protec-ted to the greatest extent for possible cochlear implanting.

Female ; Humans ; Pregnancy ; Septate Uterus ; Uterus/surgery* ; Hysteroscopy/methods* ; Estrogens ; Tissue Adhesions/surgery* ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic

Dendritic cell-based cancer vaccines (DC vaccines) have been proved efficient and safe in immunotherapy of various cancers, including melanoma, ovarian and prostate cancer. However, the clinical responses were not always satisfied. Here we proposed a novel strategy to prepare DC vaccines. In the present study, a fusion protein SNU containing a secretin-penetratin (SecPen) peptide, NY-ESO-1 and ubiquitin was designed and expressed. To establish the DC vaccine (DC-SNU), the mouse bone marrow-derived DCs (BMDCs) were isolated, pulsed with SNU and maturated with cytokine cocktail. Then peripheral blood mononuclear cells (PBMCs) from C57BL/6 mice inoculated intraperitoneally with DC-SNU were separated and cocultured with MC38/MC38

Objective:To compare the histologic features of immune-mediated hepatitis (IMH) due to immune checkpoint inhibitors (ICIs) monotherapy and combined ICIs anti-angiogenesis tyrosine kinases (TKIs) targeted therapy.Methods:Twenty-one IMH patients who had liver biopsy during ICIs treatment in Zhongshan Hospital of Fudan University from 2015 to 2019 were included. Among them, ten were treated with ICIs monotherapy, and 11 were treated with combined ICIs and anti-angiogenesis targeted therapy. The histologic features of IMH were assessed by HE staining and PD-L1/2 was evaluated by immunohistochemical staining.Results:Patients treated with monotherapy ICIs presented with different levels of lobular hepatitis and portal inflammation. Besides, there were also cholangitis, endothelialitis, Kupffer cells activation and peliosisi hepatitis. Eight cases (8/10) showed mild and two cases (2/10) showed moderate hepatic injury. As for patients receiving combined ICIs and TKIs therapy, the extent of IMH was more severe, with four cases (4/11) showing moderate-severe liver injury, with confluent or bridging necrosis, portal inflammation, cholangitis, interface hepatitis. Among these, one patient developed acute severe hepatitis with massive hepatocyte necrosis and died of multisystem dysfunction. In those cases with severe liver injury, many CD8 positive lymphocytes aggregated in the portal area and hepatic sinusoid, and PD-L1 was expressed in many endothelial cells. There were both 2 cases of death in ICIs monotherapy and combination therapy group. Among the latter group, 1 patient developed acute severe hepatitis with massive hepatocyte necrosis and died of multisystem dysfunction.Conclusion:Compared with ICIs monotherapy, combined ICIs and anti-angiogenesis targeted TKIs therapy may cause overlapping hepatic injury, leading to severe IMH.

Objective To analyze the results of assessment of malaria elimination in 9 counties (districts) of Nanchang City, and explore suitable monitoring methods for malaria after elimination of the disease in this region. Methods In 2016, the data from the network reports of malaria epidemic situation, blood examinations of febrile patients, epidemiological questionnaires of local malaria cases, investigation of epidemic focuses and disposal tables were collected and analyzed in Nanchang City from 2010 to 2015. The data of malaria elimination assessment at county ( district ) level of Donghu District , Xihu District , Qingshanhu District and Wanli District in 2013 , Nanchang County and Anyi County in 2014, Jinxian County, Qingyunpu District and Xinjian District in 2015 were collected. At same time, the data of ability of the diagnosis and treatment of malaria in clinicians, the microscopical examinations of Plasmodium in the inspection personnel were collected . Totally 30 negative blood slides and all positive blood slides since 2010 were reviewed. Results From 2010 to 2015, 93 local malaria cases were reported in Nanchang City, the majority of malaria cases were imported except 2 local malaria infection cases in 2010. Totally 64027 febrile patients received blood detections for malaria, of which 101 cases were positive and the positive rate was 0.16％. The positive blood slides review rate was 100.00％ (101/101), the negative blood slides review rate was 9.69％ (6195/63926). 9 counties (districts) all passed the malaria elimination assessment at county ( district ) level . The malaria elimination assessment scores of the 9 counties (districts) were all higher than 90 points. The correct rate of inspection personnel of microscopical examinations of Plasmodium was 91.58％ (174/190), the correct rate of knowledge of the diagnosis and treatment of malaria was 95.00％ (1710/1800), the coincidence rate of blood slides review was 100 . 00％( 304/304 ) in Nanchang , the qualified rate of slides production and dyeing was 88.16％ (268/304). Conclusions All the 9 counties (districts) of Nanchang City have passed the malaria elimination assessment with high scores. After malaria elimination, the monitoring should continue to consolidate the achievements.

Objective To compare the effect of laparoscopy-assisted gastrectomy (LAG) and open D2 radical gastrectomy (OG) for gastric cancer.Methods The retrospective cohort study was conducted.The clinicopathological data of 117 patients who underwent D2 radical gastrectomy at the Guangdong General Hospital from January 2014 to December 2014 were collected.Of 117 patients,60 undergoing LAG and 57 undergoing OG were respectively allocated into the LAG group and OG group.Total gastrectomy,distal subtotal gastrectomy and proximal subtotal gastrectomy were performed according to the location of the tumor.The perigastric lymph nodes dissection was performed according to the Japanese " Gastric cancer treatment protocol" (the 14th edition).Eligible patients received the adjuvant chemotherapy of XELOX regimen according to the Guideline published by National Comprehensive Cancer Network (NCCN).Observation indicators:(1) comparison of intra-and postoperative recovery between groups;(2) stratified analysis of number of lymph node dissected;(3) relationship among surgical method,number of lymph node dissected and postoperative complication;(4) follow-up and survival.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative adjuvant chemotherapy,tumor-free survival and tumor recurrence or metastasis up to December 2016.Measurement data with normal distribution were represented as (x)± s and comparison between groups was analyzed using the independent-sample t test.Count data were analyzed using the chi-square test or Fisher exact probability.The relationship between number of lymph node dissected and postoperative complication was done using the Logistic regression model.Results (1) Comparison of intra-and post-operative recovery between groups:all the patients completed the operation successfully.Volume of intraoperative blood loss,time to postoperative anal exsufflation and duration of postoperative hospital stay were (113±36) mL,(4.3±2.1) days,(9.7±2.9) days in the LAG group and (209 ± 77) mL,(5.3 ± 2.2) days,(11.2 ± 3.9) days in the OG group,respectively,with statistically significant differences between groups (t =6.850,-2.604,-2.405,P＜0.05).Number of lymph node dissected,numbers of patients with overall complication,incisional infection,intestinal obstruction,digestive tract fistula,intra-abdominal bleeding,cardiovascular accident,pulmonary infection,urinary tract infection and death within postoperative 30 days were respectively 31±7,6,1,0,4,0,0,1,0,0 in the LAG group and 34±6,12,0,1,2,2,1,4,1,1 in the OG group,with no statistically significant difference between groups (t=0.177,x2=2.743,0.126,0.563,0.837,P＞0.05).All the patients with complications received symptomatic treatment,1 patient with abdominal bleeding in the OG group died and other patients recovered smoothly.(2) Stratified analysis of number of lymph node dissected:number of lymph node dissected in patients with total gastrectomy,distal subtotal gastrectomy and proximal subtotal gastrectomy were 35±8,29±5,27±4 in the LAG group and 34± 5,34±6,29±6 in the OG group,respectively,with no statistically significant difference between groups (t =0.846,1.052,0.934,P＞0.05).Number of lymph node dissected in patients with stage Ⅰ,Ⅱ and Ⅲ of TNM staging were respectively 31±5,32±9,31±6 in the LAG group and 34±7,32±4,35±6 in the OG group,with no statistically significant difference between groups (t =0.494,1.657,0.136,P＞0.05).(3) Relationship among surgical method,number of lymph node dissected and postoperative complication:surgical method (LAG and OG) and number of lymph node dissected were used as the independent variable and postoperative complication between groups was used as the dependent variable,the Logistic regression model showed that surgical method and number of lymph node dissected were not related factors affecting the postoperative complication (OR =1.062,2.049,95％ confidence interval:0.998-1.140,0.695-6.042,P＞0.05).(4) Follow-up and survival:108 of 117 patients (54 in each group) were followed up for 2-35 months,with a median time of 28 months.During the follow-up,numbers of patients undergoing postoperative adjuvant chemotherapy,with tumor-free survival and with tumor recurrence were 45,43,10 in the LAG group and 42,42,10 in the OG group,respectively,with no statistically significant difference in the tumor-free survival and tumor recurrence between groups (x2 =0.055,0.002,P＞0.05).Conclusion Laparoscopy-assisted D2 radical gastrectomy is safe and feasible,which equivalent to clinical effect of open radical gastrectomy,meanwhile,it also can reduce volume of intraoperative blood loss and duration of postoperative hospital stay,and accelerate recovery of postoperative gastrointestinal function.

Objective To understand and analyze the infection status of human parasites in Nanchang City, so as to offer a scientific basis for control of parasitic disease. Methods In 2014, a survey was performed according to the scheme of The 3rd National Survey of Principal Human Parasites. Intestinal parasites were surveyed among the residents in Jinxian County and Anyi County, Qingyunpu District and Qingshanhu District in Nanchang City, including the soil-transmitted nematodes (Ascaris lumbricoides, Trichuris trichiura and hookworm), Enterobius vermicularis, tapeworm and intestinal protozoa. Clonorchis sinensis was surveyed among the residents in Qingyunpu District and Qingshanhu District. Toxoplasma gondii was surveyed among the residents in two rural areas (Nanchang County and Xinjian County) and two urban areas (Donghu District and Xihu District). The ovums of the soil-transmitted nematodes, Clonorchis sinensis , tapeworm and other helminths were examined by the Kato-Katz, while Enterobius vermicularis among children was examined by cellophane anal swab, trophozoites and cysts of intestinal protozoa by saline smearing and iodine smearing , and IgG antibodies of Toxoplasma gondii by enzyme-linked immunosorbent assay (ELISA). Results Intestinal parasites were surveyed among 2424 residents in the whole city, in which 2414 residents were tested for the infection of soil-transmitted nematodes and tapeworm;1875 residents were tested for intestinal protozoa infection;74 children were tested for eggs of Enterobius vermicularis; 539 residents were tested for Clonorchis sinensis; and 2400 residents were tested for Toxoplasma gondii. Six kinds of intestinal parasites were found citywide, with a total infection rate of 9.49% (230/2424). The infection rate of soil-transmitted nematodes was 8 . 70% ( 210/2414 ) , in which the infection rate of Ascaris lumbricoides was 0.04% (1/2414), the rate of Trichuris trichiura was 0.91% (22/2414), and of hookworm was 7.83%(189/2414). The infection rate among 3 - 6 years old children of Enterobius vermicularis was 22.97% ( 17/74 ) . Tapeworm and Clonorchis sinensis were not found . The infection rate of intestinal protozoa was 0.21%(4/1875). The positive rate of Toxoplasma gondii's IgG antibody was 5.17% (124/2400). Conclusions In Nanchang City, the infection rate of soil-transmitted nematodes (Ascaris lumbricoides, Trichuris trichiura) and intestinal protozoa was lower. However, the infection rates of hookworm, Toxoplasma gondii and Enterobius vermicularis among 3 - 6 years old children are increasing in local areas. That should be the focus in prevention and control of parasitic disease in the future.

Objective To analyze the epidemiological characteristics of malaria and to discover the regularity of malaria outbreaks in Nanchang City from 1950 to 2015, so as to provide a scientific basis for developing control strategies after the goal of malaria elimination has been achieved. Method Malaria related data, report forms and work summary in Nanchang from 1950 to 2015 were collected and analyzed to indicate malaria distribution characteristics via the descriptive epidemiological methods. Results The total number of malaria cases reported in Nanchang City was 1449878 from 1950 to 2015. The particular years with the three peaks of malaria epidemic from 1950s to 1970s were 1954, 1970 and 1977. The climax of annual mean incidence rate of malaria (6948.75 per 100 thousand) was reached in 1970. Totally 1449739 local recurrence cases were reported between 1950 and 1999. There were 484292 local recurrence cases (accounting for 68.80%, 484292/703911) that were diagnosed in the malaria epidemic seasons, May to August. There were 44931, 25684, 22614 and 5842 cases reported in Nanchang County, Xinjian County, Jinxian County and Qingshanhu District, which ranked the top 4 of epidemic focus areas ( accounting for 90 . 65%, 99071/109293) between 1980 and 1989. The 13245 cases reported between 1972 and 1985 in the three county/districts (Jinxian County, Xihu District and Wanli District), included 8513 cases of male and 4732 cases of female. The 126 cases reported between 2005 and 2015, included 122 imported cases who were mostly returnees after overseas labor output and 57 falciparum malaria cases with a increasing trend year by year. There was no correlation between the seasonal change and the occurrence of malaria. Conclusions The comprehensive prevention and control measures based on eliminating the source of infection can effectively control the epidemic of malaria. It is suggested that the surveillance on imported falciparum malaria cases should be the focus in prevention and control of the disease at the late-stage because the epidemiological characteristics of local malaria cases have died out completely.