BACKGROUND: This study aims to compare the efficacy between neoadjuvant immune checkpoint inhibitors (ICIs) plus chemotherapy vs . chemotherapy, and neoadjuvant triplet vs . doublet chemotherapeutic regimens in locally advanced gastric/esophagogastric junction cancer (LAGC). METHODS: We included LAGC patients from 47 hospitals in China's National Cancer Information Database (NCID) from January 2019 to December 2022. Using propensity score matching (PSM), we retrospectively analyzed the efficacy between neoadjuvant ICIs plus chemotherapy vs . chemotherapy alone, and neoadjuvant triplet vs . doublet chemotherapeutic regimens. The primary study result was the pathologic complete response (pCR) rate. The secondary study results were disease-free survival (DFS) and overall survival (OS). RESULTS: A total of 1205 LAGC patients were included. After PSM, the ICIs plus chemotherapy and the chemotherapy cohorts had 184 patients each, while the doublet and triplet chemotherapy cohorts had 246 patients each. The pCR rate (14.13% vs . 7.61%, χ2 = 4.039, P = 0.044), and the 2-year (77.60% vs . 61.02%, HR = 0.67, 95% con-fidence interval [CI] 0.43-0.98, P = 0.048) and 3-year (70.55% vs . 61.02%, HR = 0.58, 95% CI 0.32-0.93, P = 0.048) DFS rates in the ICIs plus chemotherapy cohort were improved compared to those in the chemotherapy cohort. No significant increase was observed in the OS rates at both 1 year and 2 years. The pCR rates, DFS rates at 1-3 years, and OS rates at 1-2 years did not differ significantly between the doublet and triplet cohorts, respectively. No differences were observed in postoperative complications between any of the group comparisons. CONCLUSIONS Neoadjuvant ICIs plus chemotherapy improved the pCR rate and 2-3 years DFS rates of LAGC compared to chemotherapy alone, but whether short-term benefit could translate into long-term efficacy is unclear. The triplet regimen was not superior to the doublet regimen in terms of efficacy. The safety after surgery was similar between either ICIs plus chemotherapy and chemotherapy or the triplet and the doublet regimen.
Humans ; Stomach Neoplasms/metabolism* ; Female ; Neoadjuvant Therapy/methods* ; Immune Checkpoint Inhibitors/therapeutic use* ; Male ; Middle Aged ; Propensity Score ; Retrospective Studies ; Aged ; Receptor, ErbB-2/metabolism* ; Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Disease-Free Survival ; Cohort Studies

Value-added assessment is a developmental and formative evaluation that focuses on the process, and its essence is to pay attention to the progress and changes of students. This method can promote the scientific, objective and fair evaluation of education. This review describes the connotation of value-added assessment, related assessment tools, and the research status of value-added assessment in medical education in China and abroad, and puts forward relevant suggestions and enlightenment on education reform of value-added assessment for the current problems in the application of value-added assessment in medical education, so as to provide a reference for establishing a scientific evaluation orientation for medical education, and for improving the comprehensive quality of students and the fair and just development of education.

Value-added assessment is a developmental and formative evaluation that focuses on the process, and its essence is to pay attention to the progress and changes of students. This method can promote the scientific, objective and fair evaluation of education. This review describes the connotation of value-added assessment, related assessment tools, and the research status of value-added assessment in medical education in China and abroad, and puts forward relevant suggestions and enlightenment on education reform of value-added assessment for the current problems in the application of value-added assessment in medical education, so as to provide a reference for establishing a scientific evaluation orientation for medical education, and for improving the comprehensive quality of students and the fair and just development of education.

Objective:In order to improve the learning interest and teaching effect,it is absolutely necessary to design a physical courseware which was suitable for medical students.Taken standing wave as an example,designing and making process of the courseware was introduced in detail.Methods:Using GUI in MATLAB software,the key steps of making the courseware were given.Results:In the interface of the physical courseware,standing wave,damped vibration and forced vibration can be demonstrated real-timely after fixed parameters of the physical process.And it was testified in the course of actual teaching and autonomous learning.Conclusion:The physical courseware was designed and made by the GUI in the MATLAB software.The results are scientific and precise.Furthermore,it is not difficult to make a courseware on the base of the preliminary ability in using MATLAB.In short,GUI is not difficult to learn and it is useful for teachers to design individual courseware.

Objective To study the effects of vaginal estrogen application on blood flow of the lower urinary tract in post-menopausal women. Methods Arterial blood flow frequency spectrum, peak systolic blood flow, end-diastolic blood flow velocity and resistance index of the peri-urethra and neck of the urinary bladder, as well as changes in their genitourinary system, were measured with color Doppler ultrasound imaging in post-menopausal women before and three months after their use of premarin ointment containing natural estrogen per vagina. Results Three months after treatment with estrogen-premarin ointment per vagina in post-menopausal women, their peak systolic blood flow velocity of the peri-urethra arteries increased to 13.23 cm/s from 11.94 cm/s before treatment, end-diastolic blood flow velocity increased to 3.92 cm/s from 1.91 cm/s and resistance index decreased to 2. 79 from 3. 84 (P <0. 01 ). And, their peak systolic blood flow velocity of the arteries of the neck of the urinary bladder increased to 17.09 cm/s from 12. 77 cm/s before treatment, end-diastolic blood flow velocity increased to 2. 83 cm/s from 1.31 cm/s and resistant index decreased to 2. 78 from 3.78 (P<0.01). It indicated that local vasodilatation and decrease dresistance of the lower urinary tract made blood flow of the arteries of the peri-urethra and neck of the urinary bladder increase, urinary frequency and nocturia occurrence decrease, and sexual satisfaction improve.Conclusions Blood flow, symptoms of the lower urinary tract and their quality of life can be improved in post-menopausal women after treatment with natural estrogen-premarin ointment per vagina.

BACKGROUND: Transcranial Doppler(TCD) spectrum analysis techniques cannot measure the diameters of blood vessels and therefore and not be used to calculate the changes of brain blood flow. A formula was designed for regional cerebral blood flow loss index(rCBFLI) following arteriostenosis when arteriostenosis index formula was deduced; the former may provide a reference to assess cerebral function.OBJECTIVE: To introduce the formula of cerebral blood flow loss ratio obtained basing on TCD results.DESIGN: Retrospective controlled study based on patients with cerebral middle arteriostenosis diagnosed with TCD and healthy people.SETTING: At the departments of neurology in a university hospital and in a military medical university affiliated hospital of Chinese PLA.PARTICIPANTS: Between October 1994 and December 2000,43 patients who were confirmed of arteriostenosis with TCD at outpatient or neurological ward of the First Affiliated Hospital of Fujian Medical University were enrolled into this study,and their TCD results were compared with 908 normal controls between March 1992 and September 2000.METHODS: Stenosis index (STI) formula was deduced from TCD results of 31unilateral and 12 bilateral stenoses at middle cerebral artery(MCA) . STI = 1- [ normal average blood velocity (Vm0) ÷ average blood velocity at stenosisSince(PI1 ÷PI0) may be equal to [post-stenosis blood flow(Q1) ÷ normal blood flow(Q0)],regional cerebral blood flow loss index is concluded as:MAIN OUTCOME MEASURES: rCBFLI,relationship between STI and Vm,as well as between rCBFLI and STI.RESULTS: rCBFLI formula was used to calculate the rCBFLI of 31 patients following unilateral MCA stenosis. rCBFLI of these 31 patients was obtained by Pearson statistical analysis. STI was found to be related to the average blood velocity at stenosis with relative coefficient(Vm) of(r) =0.76( P ＜ 0. 001 )and r = 0. 83 ( P ＜ 0. 001 ) . rCBFLI was proved to be correlated with Vm and STI with r = 0. 76( P ＜ 0. 01 ) and r = 0. 81 in 55 side MCA stenoses,and the difference was of statistical significance( P ＜ 0. 001 ).CONCLUSION: rCBFLI can be used to assess the decrement of regional brain blood flow due to the stenosis of supplying artery; also,it can be used to observe the changes of brain hemodynamics if combined with STI.

In order to discuss the evaluation method of human upper limb movements, the patterns of movement coordination during healthy people prehension have been researched. Eight subjects were asked to perform different reaching-grasping and drinking water from the cup tasks with different indices of difficulty, and the arm movement trajectories and the main muscles group electromyography (EMG) data were collected. To explore the prehension control mechanism, a comparison has been made between the solution of the theoretic calculation and the experimental data. The results show that the topological invariance was observed in the trajectories of different task performance, and the linear relationships between joints covariation were exhibited. Moreover, the different muscles were controlled and combined into units of synergistic muscular group necessary to reach and grasp the goal.
Adult ; Electromyography ; Hand ; physiology ; Hand Strength ; physiology ; Humans ; Male ; Models, Biological ; Range of Motion, Articular ; physiology ; Upper Extremity ; physiology

OBJECTIVETo investigate the effects of two different dosages of conjugated equine estrogen (CEE) on preventing bone loss and relieving the symptoms of menopausal syndrome in women at an early stage of menopause.

METHODSA total of 236 postmenopausal women were randomly allocated to one of the following groups: Group A: 0.625 mg CEE + 2 mg medroxyprogesterone acetate (MPA) + 1 tab Caltrate-D per day; Group B: 0.3 mg CEE + 2 mg MPA + 1 tab Caltrate-D per day; Group C: 1 tab Caltrate-D per day as the control group. The study was continued for 2 years.The following parameters were monitored: (1) L2-4 bone mineral density (BMD) (measured with dual energy X-ray absorptiometry (DEX)), (2) menopausal syndrome improvement (assessed by comparing Kupperman scores), (3) vaginal bleeding rate, and the thickness of the endometrium and breast in each group.

RESULTSOverall, 213 cases (90%) completed the 1-year study and 176 cases (75%) completed the 2-year study. The percentage changes in L2-4 BMD at the 12th and 24th month in Group A were +2.3% and +3.7%, respectively, with the posttreatment values being significantly higher than pretreatment values (P < 0.001). The percentage changes were +2.7% at 12th month (P < 0.05) and +0.7% at 24th month (P > 0.05) in Group B. And that of Group C were -0.4% at 12th month and -1.6% at 24th month (P > 0.05). L2-4 BMD in both Group A and B was significantly higher than that in Group C at 12th and 24th month (A vs C, P < 0.001; B vs C, P < 0.05). Kupperman Scores were significantly reduced after 1, 3, 6, 12 and 24 months in all 3 groups when compared with baseline (P < 0.001). Scores in Group A and Group B were significantly lower than that in Group C (P < 0.001). However, the vaginal bleeding rates in Group A were significantly higher than that in Group B or in Group C. There was no atypical hyperplasia of endometrium in the 3 groups by the end of the study. One patient in Group A developed superficial thrombophlebitis by the end of 12th month.

CONCLUSIONContinuous combination of CEE and MPA is effective in preventing bone loss and relieving the symptoms of menopausal syndrome in women at an early stage of menopause. The vaginal bleeding rates in the Group treated with 0.625 mg/d CEE were significantly higher than those treated with 0.3 mg/d CEE.

Alkaline Phosphatase ; blood ; Bone Density ; drug effects ; Endometrium ; pathology ; Estrogens, Conjugated (USP) ; administration & dosage ; Female ; Hormone Replacement Therapy ; adverse effects ; methods ; Humans ; Menopause ; Middle Aged ; Progestins ; administration & dosage ; Uterine Hemorrhage ; epidemiology

Aim To explore the anti-angiogenic effect of tetramethylpyrazine(TMP) in the synovium of collagen-induced arthritis(CIA) in rats.Methods CIA rats were treated with different doses of TMP.The effects of treatment were monitored by arthritis index,footpad thickness,microvessels density as well as the expression of vascular endothelial growth factor(VEGF) protein and mRNA in the synovium.Results Compared with CIA models,100 mg?kg~(-1)?d~(-1) TMP remarkably reduce the arthritis index,footpad thickness,microvessels density,and the expression of VEGF protein and mRNA in the synovium (P

Aim To study the effect of tetramethylpyrazine(TMP) on binding of 125I-VEGF to VEGF receptor. Methods The mice sera were collected after peritoneal injection with big-dose TMP,low-dose TMP,protamine and NS. A reversed-phase high performance liquid chromatography(RP-HPLC) method was used to determine the TMP in mice serum. The culture medium of ECV304 was treated with the mice sera in different groups. Radioligand binding assay(RBA) of receptor and Scatchard pot were performed to observe the changes of the maximum binding capacity(B_ max) and dissociation constant(K_d).Results The sera of big-dose TMP inhibited 125I-VEGF binding to its receptor, K_d=343.30?36.64 pmol?L-1,B_ max=46.26?5.85 fmol/2?10~5 cells(P0.05),but B_ max decreased(P