Objective To compare the efficacy and safety of CT-guided percutaneous radiofrequency ablation(RFA)and cryoablation(CRYO)combined with synchronous biopsy of pulmonary nodules.Methods Totally 62 patients with pulmonary nodules who underwent CT-guided percutaneous ablation with either RFA(n=30)or argon-helium CRYO(n=32)combined with simultaneous biopsy were enrolled,and the regarding postoperative complication rates and 1-year local control outcomes were compared.Results All patients successfully completed both ablation and biopsy procedures.In RFA group,the mean diameter of lesion was(1.43±0.33)cm,and the biopsy positive rate was 90.00%(27/30).Post-biopsy intrapulmonary hemorrhage extent immediately increased by 0.60(0.28,1.63)cm.Hemoptysis,pneumothorax requiring chest tube placement and infectious cavities observed in 2(2/30,6.67%),6(6/30,20.00%)and 4 cases(4/30,13.33%),respectively,and the 1-year local control rate in RFA group was 90.00%(27/30).In CRYO group,the mean diameter of lesion was(1.59±0.34)cm,and the biopsy positive rate was 100%(32/32).Post-biopsy intrapulmonary hemorrhage extent increased by 1.20(0.60,1.83)cm.Hemoptysis occurred in 7 cases(7/32,21.88%),and pneumothorax requiring chest tube placement was noticed in 8 cases(8/32,25.00%),while no infectious cavity was observed.The 1-year local control rate in CRYO group reached 96.88%(31/32).Statistical difference of infectious cavity was found between groups(P＜0.05).Conclusion Simultaneous biopsy during CT-guided percutaneous RFA and CRYO for lung nodules were both efficient and safe,while the former with relative higher incidence of infectious cavity.

Objective To compare the efficacy and safety of CT-guided percutaneous radiofrequency ablation(RFA)and cryoablation(CRYO)combined with synchronous biopsy of pulmonary nodules.Methods Totally 62 patients with pulmonary nodules who underwent CT-guided percutaneous ablation with either RFA(n=30)or argon-helium CRYO(n=32)combined with simultaneous biopsy were enrolled,and the regarding postoperative complication rates and 1-year local control outcomes were compared.Results All patients successfully completed both ablation and biopsy procedures.In RFA group,the mean diameter of lesion was(1.43±0.33)cm,and the biopsy positive rate was 90.00%(27/30).Post-biopsy intrapulmonary hemorrhage extent immediately increased by 0.60(0.28,1.63)cm.Hemoptysis,pneumothorax requiring chest tube placement and infectious cavities observed in 2(2/30,6.67%),6(6/30,20.00%)and 4 cases(4/30,13.33%),respectively,and the 1-year local control rate in RFA group was 90.00%(27/30).In CRYO group,the mean diameter of lesion was(1.59±0.34)cm,and the biopsy positive rate was 100%(32/32).Post-biopsy intrapulmonary hemorrhage extent increased by 1.20(0.60,1.83)cm.Hemoptysis occurred in 7 cases(7/32,21.88%),and pneumothorax requiring chest tube placement was noticed in 8 cases(8/32,25.00%),while no infectious cavity was observed.The 1-year local control rate in CRYO group reached 96.88%(31/32).Statistical difference of infectious cavity was found between groups(P＜0.05).Conclusion Simultaneous biopsy during CT-guided percutaneous RFA and CRYO for lung nodules were both efficient and safe,while the former with relative higher incidence of infectious cavity.

Objectives:This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) .Methods:From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy.Results:The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients.Conclusion:Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.

【Objective】 To evaluate the efficacy and safety of plasma-derived human coagulation factor Ⅷ (FⅧ) in the treatment of patients with hemophilia A. 【Methods】 A multi-center and open, SAT(single-arm trials) clinical study was conducted. A total of 54 subjects with hemophilia A were enrolled in 5 research centers. FⅧ was injected according to the subjects' weight, severity of disease and other factors, and the transfusion efficiency of FⅧ activity at 10 min after the first infusion of the first bleeding event was taken as the main efficacy indexes. The improvement scores of bleeding symptoms and signs within 24 h after the first infusion of the first bleeding event were the secondary efficacy indexes. The pathogenic microbial indexes and FⅧ inhibitors were detected on 90(th) and 180(th) day after treatment. 【Results】 The transfusion efficiency of FⅧ activity of 54 subjects at 10 min after the first infusion was 171.9% on average, with median of 169.5%, both higher than the target value of 100%. Within 24 h after the first infusion, the improvement of bleeding symptoms and signs of the subjects were scored, among which 19 cases (35.2%) were "obvious", 35 cases (64.8%) were "good", and the total clinical effective rate reached 100%. Five subjects (9.3%) had six drug-related adverse events. On 90(th) and 180(th) day after treatment, hepatitis B surface antigen, hepatitis C antibody, HIV antibody, treponema pallidum antibody and FⅧ inhibitors were detected, and no negative to positive cases were found. 【Conclusion】 After infusion, the FⅧ preparation can significantly improve the FⅧ activity level in hemophilia A patients in a short period of time, which has high infusion efficiency and can achieve better treatment efficacy, and can also effectively control and relieve bleeding symptoms and signs, with good overall safety.

Objective:To investigate the efficacy and safety of flumatinib in the treatment of imatinib-resistant or imatinib-intolerant patients with chronic phase chronic myelogenous leukemia (CML-CP).Methods:The clinical data of 9 CML-CP patients who received flumatinib after imatinib resistance or intolerance in Jining No. 1 People's Hospital from April 2020 to May 2021 were retrospectively analyzed. Patients were evaluated for the hematologic, cytogenetic and molecular responses, progression-free survival (PFS), event-free survival (EFS), and adverse reactions.Results:Among 9 CML-CP patients, there were 4 imatinib-resistant patients and 5 imatinib-intolerant patients. The median duration of flumatinib exposure was 17 months (1-25 months). Except for 1 case who discontinued flumatinib early due to grade 4 thrombocytopenia and other adverse reactions, 7 of the remaining 8 cases achieved the best response at 3, 6 and 12 months of flumatinib therapy. By the end of follow-up in April 2022, 7, 7 and 6 patients achieved complete cytogenetic response (CCyR), major molecular response (MMR) and molecular response 4.5 (MR4.5), respectively. The median time to achieving CCyR, MMR and MR4.5 was 4.5 months (3-6 months), 12 months (3-12 months) and 15 months (3-21 months), respectively. Within 17 months (11-25 months) of follow-up, 7 of the 9 patients had EFS and 8 patients with continuous flumatinib had PFS. Among 9 patients treated with flumatinib, hematologic adverse reactions were observed in 6 cases, and grade 3-4 hematologic adverse reactions occurred in 2 cases. Non-hematologic reactions events mainly included diarrhea (4 cases), muscle ache (2 cases), fatigue (2 cases) and liver damage (2 cases), which were all grade 1-2.Conclusions:Flumatinib is effective and well tolerated in the treatment of imatinib-resistant or imatinib-intolerant CML-CP patients.

Objective:To investigate the therapeutic effect and prognosis of percutaneous balloon kyphoplasty (PKP) for diabetic patients with osteoporotic thoracolumbar compression fractures.Methods:A total of 105 patients with diabetes mellitus complicated with osteoporotic thoracolumbar compression fractures who received diagnosis and treatment in our hospital from May. 2017 to Feb. 2020, who were followed up to Mar. 2022 were selected as the research subjects, and all were treated with PKP. Time, intraoperative blood loss, hospital stay, incidence of secondary vertebral fracture, anterior height of injured vertebral body, Sagittal kyphosis Cobb angle, VAS score, and ODI index were investigated. The patients were divided into good prognosis group ( n=82) and poor prognosis group ( n=23) according to the presence or absence of secondary vertebral fractures during the follow-up period. Binary Logistic regression model was used to analyze the risk factors affecting the prognosis. Results:After PKP treatment, the efficiency of all 105 patients was 87.62% and the incidence of secondary vertebral fracture was 21.90%. The operative time was (83.52±16.85) min, the intraoperative blood loss was (32.11±1.52) ml, and the length of hospital stay was (10.62±1.65) d. The height of the anterior edge of the injured vertebra was (24.62±5.16) mm and (24.67±5.03) mm at the last follow-up and 3 months after surgery, respectively, higher than that before surgery ( t=15.21, 15.63, P=0.000). The Cobb angle of sagittal kyphosis was (10.03±1.27) ° and (10.10±1.25) °, respectively, and the VAS score was (3.11±0.52) and (1.00±0.11) points, respectively, 3 months after surgery and at the last follow-up. The ODI indexes were (11.25±2.85) % and (5.32±1.01) %, respectively, lower than those before surgery ( t3 months after surgery=28.84, 18.17, 29.21, tlast follow-up=25.68, 27.49, 42.78, P=0.000). There were significant differences in age, BMD, bone cement leakage, bone cement distribution and use of anti-osteoporosis drugs between the good prognosis group and the poor prognosis group ( t=4.03, 5.22, χ2=12.50, 22.694, 26.22, P=0.000). Logistic regression analysis showed that age ( OR=1.309, 95%CI=1.134-1.511, P=0.000), BMD ( OR=126.660, 95%CI=13.376-1199.376, P=0.000), bone cement leakage ( OR=4.698, 95%CI=1.306-16.902, P=0.018), dense distribution of bone cement ( OR=9.697, 95%CI=2.679-34.869, P=0.001), no use of anti-osteoporosis drugs ( OR=7.586, 95%CI=2.197-26.193, P=0.001) was an independent risk factor for the prognosis of patients with diabetes complicated with osteoporotic thoracolumbar compression fracture. Conclusion:PKP has a high rate of excellence in the treatment of diabetes mellitus complicated with osteoporotic thoracolumbar compression fractures, but factors such as age, BMD, bone cement leakage, bone cement dense distribution, and no postoperative use of anti-osteoporotic drugs will increase risks of secondary fractures, which in turn affects their prognosis.

Microplastics pollution has attracted worldwide attention. Compared with the status quo of microplastics pollution in marine environment and other major rivers and lakes, the relevant data of the Yellow River basin is relatively inadequate. The abundance, types, and spatial distribution characteristics of microplastic pollution in the sediments and surface water of the Yellow River basin were reviewed. Meanwhile, the status of microplastic pollution in the national central city and Yellow River Delta wetland was discussed, and the corresponding prevention and control measures were put forward. The results showed that the spatial distribution of microplastics pollution in sediments and surface water of the Yellow River basin increased from upstream to downstream, especially in the Yellow River Delta wetland. There are obvious differences between the types of microplastics in sediment and surface water in the Yellow River basin, which is mainly related to the materials of microplastics. Compared with similar regions in China, the microplastics pollution levels in national key cities and national wetland parks in the Yellow River basin are in the medium to high degree, which should be taken seriously. Plastics exposure through various ways will cause serious impact on aquaculture and human health in the Yellow River beach area. To control microplastic pollution in the Yellow River basin, it is necessary to improve the relevant production standards, laws and regulations, and improve the capacity of biodegradable microplastics and the degradation capacity of plastic wastes.
Humans ; Microplastics ; Plastics ; Water Pollutants, Chemical/analysis* ; Environmental Monitoring/methods* ; Water ; China

Objective:To explore the clinical value of metagenomics next-generation sequencing (mNGS) in the diagnosis of urinary calculi with secondary infection.Methods:From September 2021 to May 2022, a total of 110 urinary calculi patients from the First People′s Hospital of Zhejiang Province Tonglu County were collected retrospectively, the urine sample of the patients with bacterial meningitis was measured by urine bacterial culture and mNGS respectively. Taking urine bacterial culture as the "gold standard", the sensitivity, specificity, positive predictive value, negative predictive value, and Kappa consistency of mNGS in the diagnosing of urinary calculi with secondary infection were analyzed. Results:The positive of urine bacterial culture were 35 cases and negative were 75 cases; while positive and negative were 39 cases and 71 cases in the mNGS detection. Taking urinary bacterial culture as the "gold standard", the specificity, sensitivity, positive predictive value, negative predictive value and Kappa consistency coefficient of mNGS in the diagnosis of secondary infection of urinary calculi were 89.3%, 88.6%, 79.5%, 94.4% and 0.756 respectively. Compared with urine bacterial culture, the Kappa consistency coefficients of three common pathogens detected by the mNGS of macrogenomics, included escherichia coli, klebsiella pneumoniae and enterococcus faecalis were 0.703, 0.735 and 0.769, respectively. Conclusions:mNGS can improve the detection rate of pathogens of secondary infection of urinary calculi, and has a high consistency with the detection results of urinary bacterial culture.

Objective:To observe the effect of pre injection of three different doses of butorphanol tartrate on postoperative pain in gynecological laparoscopic surgery.Methods:A prospective study was conducted on 172 patients who underwent gynecological laparoscopic surgery under general anesthesia at the First Affiliated Hospital of Dalian Medical University from April to December 2022. According to the random number table method, patients were divided into B1 group, B2 group, and B3 group. These three groups were given 10, 20, and 30 μ g/kg butorphanol tartrate 15 minutes before surgery, respectively. Ramsay sedation score at 10 minutes after patient administration, the pain Numerical Rating Scale (NRS) scores and Bruggrmann Comfort Scale (BCS) for resting and active states at 2, 6, 12, 24, and 48 hours after surgery, hemodynamic parameters at different time points during surgery, postoperative use of adjuvant analgesics and effective number of compressions for patient-controlled intravenous analgesia (PCIA) and the incidence of postoperative adverse reactions were recorded.Resultsl:There was no statistically significant difference in general characteristics among the three groups of patients (all P>0.05). At 10 minutes after administration, there was a statistically significant difference in Ramsay scores between groups B2 and B3 compared to group B1 (all P<0.05). At 12 and 24 hours after surgery, the resting NRS score of B3 group was lower than that of B2 group and B1 group, and B2 group was lower than B1 group (all P<0.05); At 6, 12, and 24 hours after surgery, the NRS scores of postoperative activity in the B2 and B3 groups were lower than those in the B1 group (all P<0.05); At 6 and 12 hours after surgery, the NRS score of the B3 group was lower than that of the B2 group (all P<0.05). At 6 and 24 hours after surgery, there was a statistically significant difference in BCS between groups B2 and B3 compared to group B1 (all P<0.05). There was no statistically significant difference in the hemodynamic parameters at each time point during surgery, the effective number of PCIA compressions within 48 hours after surgery, and the incidence of postoperative adverse reactions among the three groups of patients (all P>0.05). There was a statistically significant difference in the rate of postoperative addition of analgesics among the three groups ( P<0.05). Conclusions:Intravenous injection of 15 minutes before gynecological laparoscopic surgery 30 μg/kg butorphanol tartrate can achieve good analgesic effects with fewer adverse reactions, and can be used as a priority dose for preventive analgesia in gynecological laparoscopic surgery.

Objective:To evaluate the clinical efficacy and safety of fecal microbiota transplantation(FMT)for the treatment of chronic functional constipation in the elderly.Methods:A total of 33 elderly patients with chronic functional constipation were included and given three sessions of FMT.Changes in fecal characteristics, constipation, mood and quality of life in these patients were evaluated using the Bristol stool form scale(BSFS), the constipation assessment scale(CAS), patient assessment of constipation symptoms(PAC-SYM), the Zung self-rating anxiety scale(SAS), the Zung self-rating depression scale(SDS), and the patient assessment of constipation quality of life(PAC-QOL)before and 12 weeks after treatment.The clinical efficacy was based on comparison between pre-and post-treatment results for each patient.Results:Clear improvement was achieved in 33 patients 12 weeks after treatment, compared with before transplantation.Post-treatment scores of the constipation assessment scale and symptom self-assessment questionnaire for patients with constipation were(8.9±1.2)scores and(26.5±2.4)scores, respectively, significantly lower than pre-transplantation scores of(12.2±1.1)scores and(32.4±2.4)scores( t=15.034, 13.904, both P<0.001). Similarly, post-treatment scores were also lower than pre-transplantation levels for the self-rating anxiety scale[(50.4±8.4)scores vs.(57.5±9.0)scores, t=10.333, P<0.001], the self-rating depression scale[(50.6±8.4)% vs.(55.0±10.5)%, t=5.301, P<0.001], and self-assessment questionnaire for quality of life[(88.2±7.3)scores vs.(103.7±7.3)scores, t=23.300, P<0.001]. Conclusions:FMT can improve fecal characteristics and constipation symptoms, relieve anxiety and depression, improve the quality of life, and provide a new option for the treatment for elderly patients with chronic functional constipation.