Malignant pleural mesothelioma(MPM)is strongly associated with a history of asbestos exposure and is characterized by high malignancy,high mortality,and poor prognosis.Current treatments for MPM are limited and generally suboptimal,resulting in a median overall survival(OS)of approximately one year for MPM patients.However,advancements in treatment options,including surgery,radiotherapy,chemotherapy,immunotherapy and targeted therapy,have brought new hope to patients with MPM.For early-stage MPM patients categorized under the TNM staging system,surgical treatment is feasible and can improve survival rates and quality of life.However,there is still debate regarding the optimal surgical approach for MPM.In addition to surgery,radiotherapy plays a vital role in MPM treatment.It is often used as prophylactic treatment or for alleviating local symptoms in advanced stages.Radiotherapy can also serve as neoadjuvant or adjuvant therapy in surgical contexts.For patients experiencing local progression or isolated distant metastases after systemic treatment,radiotherapy is a viable option.The advent of advanced radiotherapy techniques,such as intensity-modulated radiotherapy(IMRT)and volumetric intensity-modulated arc therapy(VMAT),has significantly improved the precision and efficacy of radiotherapy while minimizing damage to healthy tissues.Furthermore,brachytherapy can relieve pain or act as a localized supplemental therapy.Chemotherapy remains the standard treatment for MPM.The combination of pemetrexed and platinum-based drugs is widely applied as first-line therapy and has been shown to significantly extend survival.However,commonly used second-line regimens often yield suboptimal results.In recent years,immunotherapy has developed rapidly.Dual immunotherapy with nivolumab and ipilimumab has demonstrated impressive clinical efficacy and safety.The combination of immunotherapy and chemotherapy has also notably extended patients'median survival.Multiple clinical trials have confirmed that this combination therapy benefits patients.Currently available targeted therapies for MPM primarily focus on anti-angiogenesis.Bevacizumab combined with chemotherapy has established its position as a first-line treatment.Research on ramucirumab and apatinib suggests that these drugs have certain efficacy and safety profiles.Beyond conventional treatment options,the UV1 cancer vaccine combined with dual immunotherapy offers new hope for patients.Chimeric antigen receptor T(CAR-T)cell therapy is an emerging treatment method being investigated in MPM patients,with phase Ⅰ clinical trials demonstrating good antitumor effects.Additionally,some antibody-drug conjugates are becoming therapeutic options for MPM through precise targeting.Tumor treating fields combined with chemotherapy has also shown efficacy in extending survival.Despite the increasing variety of treatment options for MPM,its diagnosis and treatment still face numerous challenges,including difficulties in early detection,treatment resistance,and a lack of large-scale evidence-based clinical studies.Future research should focus on improving early diagnosis rates,developing new treatment strategies,overcoming resistance,and advancing personalized therapy.Strengthening the integration of basic research and clinical trials will also be essential.Through multidisciplinary collaboration and continuous innovation,it is hoped that more effective and safer treatment options will become available,ultimately improving the prognosis of MPM patients.

Malignant pleural mesothelioma(MPM)is strongly associated with a history of asbestos exposure and is characterized by high malignancy,high mortality,and poor prognosis.Current treatments for MPM are limited and generally suboptimal,resulting in a median overall survival(OS)of approximately one year for MPM patients.However,advancements in treatment options,including surgery,radiotherapy,chemotherapy,immunotherapy and targeted therapy,have brought new hope to patients with MPM.For early-stage MPM patients categorized under the TNM staging system,surgical treatment is feasible and can improve survival rates and quality of life.However,there is still debate regarding the optimal surgical approach for MPM.In addition to surgery,radiotherapy plays a vital role in MPM treatment.It is often used as prophylactic treatment or for alleviating local symptoms in advanced stages.Radiotherapy can also serve as neoadjuvant or adjuvant therapy in surgical contexts.For patients experiencing local progression or isolated distant metastases after systemic treatment,radiotherapy is a viable option.The advent of advanced radiotherapy techniques,such as intensity-modulated radiotherapy(IMRT)and volumetric intensity-modulated arc therapy(VMAT),has significantly improved the precision and efficacy of radiotherapy while minimizing damage to healthy tissues.Furthermore,brachytherapy can relieve pain or act as a localized supplemental therapy.Chemotherapy remains the standard treatment for MPM.The combination of pemetrexed and platinum-based drugs is widely applied as first-line therapy and has been shown to significantly extend survival.However,commonly used second-line regimens often yield suboptimal results.In recent years,immunotherapy has developed rapidly.Dual immunotherapy with nivolumab and ipilimumab has demonstrated impressive clinical efficacy and safety.The combination of immunotherapy and chemotherapy has also notably extended patients'median survival.Multiple clinical trials have confirmed that this combination therapy benefits patients.Currently available targeted therapies for MPM primarily focus on anti-angiogenesis.Bevacizumab combined with chemotherapy has established its position as a first-line treatment.Research on ramucirumab and apatinib suggests that these drugs have certain efficacy and safety profiles.Beyond conventional treatment options,the UV1 cancer vaccine combined with dual immunotherapy offers new hope for patients.Chimeric antigen receptor T(CAR-T)cell therapy is an emerging treatment method being investigated in MPM patients,with phase Ⅰ clinical trials demonstrating good antitumor effects.Additionally,some antibody-drug conjugates are becoming therapeutic options for MPM through precise targeting.Tumor treating fields combined with chemotherapy has also shown efficacy in extending survival.Despite the increasing variety of treatment options for MPM,its diagnosis and treatment still face numerous challenges,including difficulties in early detection,treatment resistance,and a lack of large-scale evidence-based clinical studies.Future research should focus on improving early diagnosis rates,developing new treatment strategies,overcoming resistance,and advancing personalized therapy.Strengthening the integration of basic research and clinical trials will also be essential.Through multidisciplinary collaboration and continuous innovation,it is hoped that more effective and safer treatment options will become available,ultimately improving the prognosis of MPM patients.

Objective: To establish a set of rules for autoverification of blood analysis, in order to provide a way to validate autoverification rules for different analytical systems, which can ensure the accuracy of test results as well as shorten turnaround time (TAT) of test reports. Methods: A total of 34 629 EDTA-K2 anticoagulated blood samples were collected from multicenter cooperative units including the First Hospital of Jinlin University during January 2017 to November 2017. These samples included: 3 478 cases in Autoverification Establishment Group, including 288 cases for Delta check rules; 5 362 cases in Autoverification Validation Group, including 2 494 cases for Delta check; 25 789 cases in Clinical Application Trial Group. All these samples were analyzed for blood routine tests using Sysmex XN series automatic blood analyzers.Blood smears, staining and microscopic examination were done for each sample; then the clinical information, instrument parameters, test results and microscopic results were summarized; screening and determination of autoverification conditions including parameters and cutoff values were done using statistical analysis. The autoverification rules were input into Sysmex Laboman software and undergone stage Ⅰ validation using simulated data, and stage Ⅱ validation for post-analytical samples successively. True negative, false negative, true positive, false positive, autoverification pass rate and passing accuracy were calculated. Autoverification rules were applied to autoverification blood routine results and missed detection rates were validated, and also data of autoverification pass rate and TAT were obtained. Results: (1)The selected autoverification conditions and cutoff values included 43 rules involving WBC, RBC, PLT, Delta check and abnormal characteristics. (2)Validation of 3 190 cases in Autoverification Establishment Group showed the false negative rate was 1.94%(62/3 190)(P<0.001), autoverification pass rate was 76.74%, passing accuracy was 97.47%; Validation of 2 868 cases in Autoverification Validation Group, the false negative rate was 3.38%(97/2 868)(P=0.002), autoverification pass rate was 42.26%, passing accuracy was 92.00%; Validation of Delta check on 288 cases in Autoverification Establishment Group and 2 494 cases in Autoverification Validation Group showed the false negative rates were respectively 1.39% and 2.61%(P<0.001). (3)Three hospitals adopted these rules of autoverification for 25 789 blood routine samples, and found that the average TAT of blood routine test reports were shortened by 24min, 32min and 7min respectively, the rate of samples reported within 30min were elevated by 33%, 53% and 7%. The autoverification pass rates were 72%-74%. Conclusions The application of this set of 43 autoverification rules in blood sample analysis can ensure test quality while shortenTAT and improve work efficiency. It is worth pointing out that for the same analytical systems in this research, validation is necessary before application of this set of rules, and periodic validation is required during application to make necessary adjustment; for different analytical systems, as this research provide a way to establish autoverification rules for blood routine tests.Clinical labs may establish their own suitable autoverification rules on the basis of technological parameters. (Chin J Lab Med, 2018, 41: 601-607)

Objective To investigate the clinical efficacy of the procedure for prolapse and hemorrhoids (PPH) plus external dissection and internal ligation in small incisions in the treatment of circumferential mixed hemorrhoids.Methods From January 2015 to January 2017,168 patients with annular mixed hemorrhoids in the People's Hospital of Qingzhou were selected.All cases were treated with PPH combined with small incision exfoliation and internal ligation.The clinical data of 168 patients were analyzed.Results Average operation time was 25 minutes;average hospital stay time was 6 days;168 cases were all cured,2 cases suffered from anal margin edema,7 cases urinary retention.There was no complications such as anal stricture,fecal incontinence etc.Conclusion PPH plus external dissection and internal ligation in small incisions in the treatment of circumferential mixed hemorrhoids has such multiple advantages as small incision,minor trauma,exact efficacy,less complications after operation and shorter hospital stay.

BACKGROUND:Conventional dynamic hip screw or artificial joint replacement can be used to treat unstable intertrochanteric fracture in aged patients. It remains unclear whether we should select one-stage replacement or remedial joint replacement after failture, and there is no unified standard globaly. OBJECTIVE: To observe the outcomes and prognosis of one-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients. METHODS:From April 2008 to October 2011, 21 patients with unstable intertrochanteric fracture in aged patients were repaired with one-stage artificial joint replacement at the Second Department of Orthopedics, Changji Prefecture People’s Hospital. Among 21 patients, 1 patient previously combined with avascular necrosis of the femoral head and traumatic arthritis received biological artificial total hip replacement. Three cases were subjected to standard bone cement bipolar artificial femoral head replacement. 17 cases underwent biological bipolar artificial femoral head prosthesis replacement. Al artificial joint, internal fixation material and accessory joint replacement surgical instruments were purchased outside China. Al patients were folowed up regularly. Hip joint function was assessed by Harris hip score. RESULTS AND CONCLUSION: Al operations were completed by the same group of physicians. Operation time was 30-60 minutes, averagely 42 minutes. Incision length was 8 to 15 cm, averagely 11 cm. Average intraoperative blood loss was 50-300 mL, averagely 150 mL. The number of transfusion cases was 13. 1.5 U blood was transfused averagely in each patient during hospital stay. One 76-year-old patient combined with hypertension, coronary heart disease and diabetes suffered from sudden death due to acute myocardial infarction at 9 days after replacement. B ultrasound revealed venous thrombosis of calf muscle of double lower extremities at 3 days after replacement. No complications such as prosthetic loosening, sinking, infections and thrombosis were detected. Except 1 case died, the other 20 cases received folow-up for 6-49 months. Harris hip score was 73±4 before discharge and 82±6 during last folow-up. These data confirm that effects of one-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients are affirmative, but the number of case is stil less, and deserves further investigations. We suggest that in patients with conformed indication, one-stage artificial joint replacement can be the first choice.

Objective To observe the targeted function of a mesothelin antibody modified nanoprobe in human pancreatic cancer BxPC3 cell.Methods The Fe3O4@SiO2 nanoprobe was prepared by St(o)ber method,and then quantum dots (CdTe) and mesothelin antibody was crosslinked to obtain the properties of targeting and fluorescent.Fluorescent nano Fe3O4@SiO2 probes and BxPC3 cells were incubated in vitro for 30 min.Its targeting performance was tested by the CCD imaging system and magnetic separation technology.HepG-2 and K562 cells with low expression of mesothelin were selected as reference cells.Results This preparation method of nanoprobe could produce a uniform and narrow distribution particle with particle size mainly ranging from 120 to 140 nm.The cell adsorption experiments showed that the adsorption efficiency of BxPC3,HepG-2 and K562 by nanoprobe without crosslinking antibody were less than 20％,as a non-specific adsorption; and the adsorption efficiency of BxPC3,HepG-2 and K562 by crosslinking mesothelin antibody nanoprobe were (53.9 ± 1.8) ％,(8.0 ± 2.1) ％ and (8.9 ± 2.3) ％ respectively,and the adsorption capacity with BxPC3 was significantly increased.Conclusions The nanoprobe modified by mesothelin antibody can effectively recognize BxPC3 cells which highly expressing mesothelin.

To explore the therapeutic effect of micro-traumatic surgery of loose seton and cutting seton by rubber bands in the treatment of high anorectal fistulae.Application of cutting seton (truss rubber bands) implemented the high part of fistulae and loose seton (ligation rubber band but non-fastened) for the low part of fistulae.133/136 patients undergoing micro-traumatic surgery were cured by one operation,2 cases had pseudo-healing and there was 1 recurrent case.And the curative rate was 97.8％.The microtraumatic surgery of loose seton and cutting seton by rubber bands in the treatment of high anorectal fistula has such multiple advantages as small incision,minor trauma,lesser pain,faster healing and a shorter course of treatment.And it may preserve the proper anal function and the integrity of anal skin.And its clinical efficacy is satisfactory.

BACKGROUND: As a common anticoagulant, heparin is widely used in clinic, but it has remarkable side effects such as severe bleeding and heparin-induced thrombocytopenia, and it cannot inactivate fibrin-bound thrombin. Annexin Ⅴ derivative (AND) is inosculated with C-terminal of hirudin and annexin Ⅴ, and its anticoagulation and anti-thrombosis effects are compared with those of heparin. OBJECTIVE: To investigate the relationship between quantitative effectiveness and time effectiveness of AND on coagulation and thrombosis, and study its reliability. DESIGN: Completely randomized grouping design and controlled study. SETTING: Cardiac Department of amunicipal hospital. MATERIALS: The experiment was conducted at the Animal Laboratory of Jiangsu Provincial People's Hospital from July 2000 to April 2001. Totally 32 male New Zealand white rabbits were randomly divided into 4groups, namely, high dosage AND group, low dosage AND group, common heparin group and saline group with 8 in each group. METHODS: Heparin and AND were diluted with saline.①High dosage AND group: 0.7 mg/kg AND was injected intravenously and followed by intravenous dripping of 0.35mg/(kg ·h)for 2 hours.Low dosage AND group: 0.3 mg/kg AND was injected intravenously and followed by intravenous dripping of 0.15 mg/(kg·h) for 2 hours. Heparin group: 75 IU/kg heparin was injected intravenously and followed by intravenous dripping of 37.5 IU/(kg·h) for 2 hours. Saline group: The same volume of saline and medication were used as those in drug groups.② Blood sample was collected from the femoral vein before administration so as to test blood routine, activated partial thromboplastin time(APTT)and prothrombin time (PT) after 15-, 30- and 60-minute administration and 2-hour withdrawal.③Saccule was separated from endothelium of femoral artery to measure blood pressure of distal femoral artery at 15 minutes after administration.Time of pulse pressure equal to 0 mmHg was recorded when the vessel was occluded completely by a thrombus.Finally the injured femoral arteries whose vessel was stripped were collected to measure its length, wet weight and dry weight. ④Observation of AND toxicity and sideeffects:During the experiment,vital signs of the animals were measured,such as blood pressure,heart rate and breath;in addition,bowelhemorrhage was observed and the number of leucocytes was counted after dissection of some of the animals. MAIN OUTCOME MEASURES:①Effect of AND on blood coagulation system and arterial thrombosis.②AND toxicity and side effects. RESULTS: All the 32 white rabbits entered the final analysis. ① Anticoagulant effect: APTT: Fifteen minutes after administration, APTT in AND group was the longest,which was(136.86±39.46)s in high dosage AND group and (122.90±34.19) s in low dosage ANDgroup.Moreover, APTT was longer than that in saline group [(95.14±24.64) s], but shorter than that in common heparin group [(180.00±0.00) s, P ＜ 0.05, 0.01]. At 30 minutes after administration,AND in high dosage group still had coagulation,and APTT was (124.61±40.19) s in high dosage group, which was longer than that in saline group [(85.57±27.67) s], but APTT was (112.94±43.17) sin low dosage group,which was shorter than that in common heparin group [(85.57±27.67)s,P ＜ 0.05].APTT was shorter in high and low dosage groups than in common heparin group at 60 minutes after administration (P ＜ 0.05),and longer than that in saline group 2 hours after drug withdrawal,but there was not significant difference(P ＞ 0.05).PT:PT in common heparin group was longer than that in high and low dosage groups at 15,30 and 60 minutes after administration (P ＜ 0.05).② Effect on arterial thrombosis:Wet weight of thrombus:It was lighter in AND group than in common heparin group(P ＜ 0.05). Dry weight of thrombus:Thrombus was lighter in high and low dosage groups than in common heparin group, and was lighter in high dosage group than in low dosage group (P ＜ 0.05).Thrombus length:It was shorter in low dosage group than in saline group (P ＜ 0.05), and shorter in high dosage groupthan in common heparin group (P ＜ 0.05). Time of complete occlusion: It was longer in high and low dosage groups than in saline group(P ＜ 0.05).③ AND toxicity and side effects:The behavior of rabbits in high and low dosage groups was similar to that in other two groups. Obvious hemodynamic changes were not found, and bowel hemorrhage was not observed, either. CONCLUSION: AND is an effective anticoagulant and anti-thrombosis agent; the highest anticoagulation effect occurs at 15 minutes afteradminis tration. However, the anticoagulant effect is poor as compared to heparin.The effect is poorer after 60-minute administration. Effect of AND on thrombus is stronger than that of heparin,but the size of thrombus is smaller than that of heparin, and the dosage-dependence manner was found. In addition, the anti-thrombus effect of AND is stronger in high dosage group than in low dosage group.