Objective To explore the value of MRI subtraction technique(ST)for evaluating the efficacy of systemic therapy for advanced hepatocellular carcinoma(HCC)and predicting prognosis after combining with surgery.Methods Totally 35 patients with 39 HCC lesions who received systemic therapy+radical resection were retrospectively collected.Based on preoperative MRI,tumor activity ratio(recorded as tumor activityST)was obtained with ST,while tumor activity value(recorded as tumor activitypathology)was obtained through postoperative pathology,and their correlation was analyzed.The patients were regularly followed up after surgery,and the survival data were recorded.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of tumor activityST for predicting patients'survival status.Then the patients were divided into survival benefit group and no survival benefit group according to the cut-off value,and survival analysis was conducted.Results Tumor activityST was positively correlated with tumor activitypathology(r=0.900,P＜0.001).The median follow-up time was 32.93 months,during which 8 patients died,and the median survival time was 29.9 months.The area under the curve(AUC)of tumor activityST for predicting patients'survival status was 0.67,and the cut-off value was 0.36.Thirty patients with tumor activityST＜0.36 were enrolled in survival benefit group,while 5 patients≥0.36 were collected in no survival benefit group.The overall survival in survival benefit group was longer than that in no survival benefit group(P＜0.001).Conclusion MRI ST could be used to non-invasively evaluate the efficacy of systemic therapy for advanced HCC and predict prognosis after combining with surgery.

Objective To evaluate the consistency of DNA coding region single nucleotide polymorphism(cSNP)genotyping at the DNA and RNA levels in common body fluid samples based on the next-generation sequencing platform.Methods After extensive literature retrieval,25 cSNP loci of 8 human tissue-specific mRNAs in peripheral blood,semen and vaginal secretion were selected.Two cSNP multiplex genotyping panels based on DNA and RNA,respectively,were developed for use on the MiSeq FGx sequencing platform.45 body fluid samples(including 14 peripheral blood samples,15 semen samples and 16 vaginal secretion samples)were sequenced and analyzed.The inconsistent typing results of DNA and RNA were rechecked by Sanger sequencing.Results The results of cSNP genotyping at the DNA and RNA levels in peripheral blood were completely consistent.Among the 15 semen samples,the genotypes of rs1995640 and rs 1995641 on the TGM4 gene were inconsistent in 3 cases.Among the 16 vaginal secretion samples,there were 2 cases,1 case and 2 case with inconsistent results of rs3869098,rs10947121 and rs12110470 in MUC22 gene,respectively.Conclusion In this study,MiSeq FGx sequencing and Sanger sequencing were used to test 25 cSNP loci with body fluid tissue specificity.The same typing results at the DNA and RNA levels were observed at 20 cSNPs.Inconsistent genotypes at the DNA and RNA levels were observed at 5 cSNPs on the TGM4 and MUC22 genes.This study provides experimental methods and data for forensic cSNP studies.

Objective To evaluate the consistency of DNA coding region single nucleotide polymorphism(cSNP)genotyping at the DNA and RNA levels in common body fluid samples based on the next-generation sequencing platform.Methods After extensive literature retrieval,25 cSNP loci of 8 human tissue-specific mRNAs in peripheral blood,semen and vaginal secretion were selected.Two cSNP multiplex genotyping panels based on DNA and RNA,respectively,were developed for use on the MiSeq FGx sequencing platform.45 body fluid samples(including 14 peripheral blood samples,15 semen samples and 16 vaginal secretion samples)were sequenced and analyzed.The inconsistent typing results of DNA and RNA were rechecked by Sanger sequencing.Results The results of cSNP genotyping at the DNA and RNA levels in peripheral blood were completely consistent.Among the 15 semen samples,the genotypes of rs1995640 and rs 1995641 on the TGM4 gene were inconsistent in 3 cases.Among the 16 vaginal secretion samples,there were 2 cases,1 case and 2 case with inconsistent results of rs3869098,rs10947121 and rs12110470 in MUC22 gene,respectively.Conclusion In this study,MiSeq FGx sequencing and Sanger sequencing were used to test 25 cSNP loci with body fluid tissue specificity.The same typing results at the DNA and RNA levels were observed at 20 cSNPs.Inconsistent genotypes at the DNA and RNA levels were observed at 5 cSNPs on the TGM4 and MUC22 genes.This study provides experimental methods and data for forensic cSNP studies.

Objective To explore the value of MRI subtraction technique(ST)for evaluating the efficacy of systemic therapy for advanced hepatocellular carcinoma(HCC)and predicting prognosis after combining with surgery.Methods Totally 35 patients with 39 HCC lesions who received systemic therapy+radical resection were retrospectively collected.Based on preoperative MRI,tumor activity ratio(recorded as tumor activityST)was obtained with ST,while tumor activity value(recorded as tumor activitypathology)was obtained through postoperative pathology,and their correlation was analyzed.The patients were regularly followed up after surgery,and the survival data were recorded.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of tumor activityST for predicting patients'survival status.Then the patients were divided into survival benefit group and no survival benefit group according to the cut-off value,and survival analysis was conducted.Results Tumor activityST was positively correlated with tumor activitypathology(r=0.900,P＜0.001).The median follow-up time was 32.93 months,during which 8 patients died,and the median survival time was 29.9 months.The area under the curve(AUC)of tumor activityST for predicting patients'survival status was 0.67,and the cut-off value was 0.36.Thirty patients with tumor activityST＜0.36 were enrolled in survival benefit group,while 5 patients≥0.36 were collected in no survival benefit group.The overall survival in survival benefit group was longer than that in no survival benefit group(P＜0.001).Conclusion MRI ST could be used to non-invasively evaluate the efficacy of systemic therapy for advanced HCC and predict prognosis after combining with surgery.

Objective:To develop evaluation index system of Knowledge, Attitude, and Practice Model of esophageal speech training for Otolaryngology nurse, which can provide an initial tool to evaluate the effect of esophageal speech training for Otolaryngology nurse.Methods:Based on the Knowledge, Attitude, and Practice Model and literature research, the initial dimensions and items were developed. The evaluation index system was completed by Delphi technique that 23 experts were invited to evaluate the importance of the dimensions and items in the consulting round. Then the weight value of the index system was computed through analytic hierarchy.Results:For the first and second rounds of the study, respectively, the recovery rates were 78.26% and 100.00%, the expert authority were 0.85 and 0.86, and the Kendall′s W were 0.16 and 0.19 ( P<0.05). Finally, the index system contained 3 dimensions and 30 items. Conclusions:The evaluation index system has the possible scientificity and reliability, and has the feasible thoery and content. In the future, the evaluation index system can be used to evaluate the effect of esophageal speech training for Otolaryngology nurse through the clinical practice improvement.

Objective:To retrieve, appraise and summarize the evidence for the airway humidification management of the inpatient with laryngectomy and tracheotomy but nonmechanical ventilation and to provide references for the clinical nursing.Methods:The evidence question was raised based on the study objective. The evidence was retrieved from some databases according to the evidence pyramid model during inception to December, 2018. The literature types included clinical practice guideline, evidence summary, best practice information sheet, recommended practice and systematic review. The quality of the literature were evaluated by the suitable evaluated tool based on their types. The level and recommedation grade of the evidence were appraised by the suitable tools of JBI.Results:Thirteen studies were recruited, including one clinical practice guideline, two evidence summaries, one best practice information sheet and nine systematic reviews. Totally thirteen items of best evidence were summarized and generalized to four categories including assessment, method, liquid and operation of airway humidification.Conclusion:The evidences of the studies are scientific and practical, but on the one hand, it is recommended that when applying the evidences in clinic, it is necessary to assess the clinical situation and chose the proper evidence. And on the other hand, there are lacking of some evidences of airway humidification and the level of some evidences is low. So it needs to create more high level evidences.

Objective: To explore the effect of the public welfare training of esophageal speech on the psychological condition of the laryngectomees. Methods: Using experimental research method and convenient sampling method to select 96 laryngectomees as research object by inclusion and exclusion criteria in Hubei province. The public welfare training was used to guide the laryngectomees to learn the esophageal speech. Then, laryngectomees' restoring vocalization, self-rating anxiety and self-rating depression would be assessed in a month before training, a month after training and half a year after training. The results were analyzed by descriptive analysis, chi-square test, F-test and so on. Results: Ninety-six laryngectomees participated in the public service esophageal language training one month before, one month after and half a year after the training. The number of patients recovered completely from 3 to 39 to 72 in the recovery of pronunciation function. There was significant difference in the distribution (χ²=195.579, P < 0.01). The score of anxiety and depression was (54.84±9.19), (47.41±8.16), (42.92±7.16) points and (59.00±8.87), (52.48±8.16), (47.56±7.41) points. There were significant differences (χ²=79.772, 82.705, P<0.01). Conclusions Most laryngectomees have the different degrees of anxiety and depression after surgery. By carrying out the public welfare training of esophageal speech on laryngectomees, the psychological state of the laryngectomees can be effectively improved.

Objective To explore how to optimize laboratory work flow in regional laboratory information management system (LIS) .Methods Upgraded both software and hardware ,reduced manual operation ,and to avoid the mistake and improve the effi‐ciency .Results Compared to the original process ,the optimized one reduces the time line by 57% .Furthermore ,time cost of other individual processes ,such as patient information input ,sample collection and sample classification were also shortened significantly . Conclusion By work flow rebuilding ,we not only improved the efficiency of laboratory work by saving time cost ,but also reduced the error rate ,which finally satisfied our patients .

Objective To investigate the genetic relation between Cryptococcus neoformans var.the clinical strains in MLMT - 13 genotype and the environmental strains in MLMT - 36 genotype. Methods Multilocus microsatellite typing (MLMT) method was applied for the genotype analysis in our study.Through this method, we recognized two genotypes that distinguish a majority of clinical and environmental strains. In order to compare virulence between the two types, we chose to infect BALB/c mice (6 weeks,female) with 9 MLMT-13 strains and 10 MLMT-36 strains intravenously. Results Forty( 17 clinical and 23 environmental isolates) were analyzed. Of 17 clinical strains, 9 belonged to a major type of MLMT-13 (52.9%). They were mainly isolated from clinical specimens. About 43.5% of strains from the environment belong to a major type of MLMT-36, which are indigenous to environments and which were not isolated from clinical samples. The mortality rate and pathological changes of the above mice were observed during two months after injection. The results showed that the mortality rate of mice infected with MLMT-13 strains was 100%, while the mortality rate with MLMT-36 strains was 7. 5%. The pathological sections showed that lesions of MLMT-13 infected mice appeared in the brain, lungs, liver and kidneys, while the lesions of MLMT-36 infected mice only appeared in the brain. Most brains of MLMT-13 infected mice were distorted,and both the number and size of lesions in such brains were much larger than those of MLMT-36 infected mice. Conclusion Our study illustrated the virulent difference between MLMT-13 and MLMT-36, which are isolated from patients and environment respectively. The results inferred that some genetic changes, such ss microsatellite repeats, might occur between environmental and clinical isolates through their environmental adaptation progress.