A 62-year-old male patient with esophageal squamous cell carcinoma received immunotherapy combined with chemotherapy regimen (intravenous infusions of tislelizumab 200 mg on day 1, paclitaxel liposome 240 mg and nedaplatin 120 mg on day 2, 21 days as a cycle) for a total of 4 cycles. The patient′s condition was partially relieved. Then the treatment was changed to intravenous infusion of tislelizumab 200 mg on day 1 and tegafur, gimeracil and oteracil potassium 40 mg in the morning and 60 mg in the evening by mouth from the first day to the 14th day, 21 days as a cycle. Only one cycle was given. After the last treatment (the 98th day of immunotherapy combined with chemotherapy), the patient developed acute muscle weakness, sensory impairment, and decreased tendon reflexes. Nerve conduction and electromyography showed peripheral nerve damage in the limbs. Peripheral neuropathy caused by tislelizumab was considered. The patient received the treatments of methylprednisolone sodium succinate, mecobalamin, and vitamin B 1. Nine days later, his symptom of myasthenic was improved, and pain and warm sensation was recovered gradually. Since then, the patient had not been treated with immunotherapy.

A 62-year-old male patient with esophageal squamous cell carcinoma received immunotherapy combined with chemotherapy regimen (intravenous infusions of tislelizumab 200 mg on day 1, paclitaxel liposome 240 mg and nedaplatin 120 mg on day 2, 21 days as a cycle) for a total of 4 cycles. The patient′s condition was partially relieved. Then the treatment was changed to intravenous infusion of tislelizumab 200 mg on day 1 and tegafur, gimeracil and oteracil potassium 40 mg in the morning and 60 mg in the evening by mouth from the first day to the 14th day, 21 days as a cycle. Only one cycle was given. After the last treatment (the 98th day of immunotherapy combined with chemotherapy), the patient developed acute muscle weakness, sensory impairment, and decreased tendon reflexes. Nerve conduction and electromyography showed peripheral nerve damage in the limbs. Peripheral neuropathy caused by tislelizumab was considered. The patient received the treatments of methylprednisolone sodium succinate, mecobalamin, and vitamin B 1. Nine days later, his symptom of myasthenic was improved, and pain and warm sensation was recovered gradually. Since then, the patient had not been treated with immunotherapy.

A 66-year-old male patient with anxiety and depression received lorazepam 1 mg twice daily and buspirone 10 mg twice daily. Two months later, the patient developed chills, fever, drowsiness, and stiffness of limbs, etc. Laboratory tests showed white blood cell count 13.5×10 9/L, neutrophils 0.89, C-reactive protein 68.7 mg/L, serum creatinine 211 mmol/L, direct bilirubin 10.3 mmol/L, alanine aminotransferase 96 U/L, aspartate aminotransferase 121 U/L, creatine kinase (CK) 4 557 U/L, CK-MB 83 U/L, lactate dehydrogenase 462 U/L, α-hydroxybutyrate dehydrogenase 339 U/L, and troponin 116 ng/L. Malignant syndrome caused by buspirone was considered. The drug was stopped, lorazepam was continued, and oxygen inhalation, ECG monitoring, physical cooling, anti-infection, and other treatments were given. The patient still had fever and developed deep coma, with brown urine and myoglobin >3 000 mg/L. Secondary rhabdomyolysis was considered. Anti-infection treatment was continued and treatments such as correcting electrolyte balance, alkalizing urine, and diuresis were given. On the 10th day of drug withdrawal, the patient had normal limb activity and urine color, his creatine kinase was 246 U/L, and myoglobin was 856 mg/L. One month later, the laboratory tests showed no obvious abnormalities and no malignant syndrome releted symptoms recurred. The rhabdomyolysis secondary to malignant syndrome in the patient was considered to be possibly related to buspiron and the combination with lorazepam might promote its occurrence.

A 66-year-old male patient with anxiety and depression received lorazepam 1 mg twice daily and buspirone 10 mg twice daily. Two months later, the patient developed chills, fever, drowsiness, and stiffness of limbs, etc. Laboratory tests showed white blood cell count 13.5×10 9/L, neutrophils 0.89, C-reactive protein 68.7 mg/L, serum creatinine 211 mmol/L, direct bilirubin 10.3 mmol/L, alanine aminotransferase 96 U/L, aspartate aminotransferase 121 U/L, creatine kinase (CK) 4 557 U/L, CK-MB 83 U/L, lactate dehydrogenase 462 U/L, α-hydroxybutyrate dehydrogenase 339 U/L, and troponin 116 ng/L. Malignant syndrome caused by buspirone was considered. The drug was stopped, lorazepam was continued, and oxygen inhalation, ECG monitoring, physical cooling, anti-infection, and other treatments were given. The patient still had fever and developed deep coma, with brown urine and myoglobin >3 000 mg/L. Secondary rhabdomyolysis was considered. Anti-infection treatment was continued and treatments such as correcting electrolyte balance, alkalizing urine, and diuresis were given. On the 10th day of drug withdrawal, the patient had normal limb activity and urine color, his creatine kinase was 246 U/L, and myoglobin was 856 mg/L. One month later, the laboratory tests showed no obvious abnormalities and no malignant syndrome releted symptoms recurred. The rhabdomyolysis secondary to malignant syndrome in the patient was considered to be possibly related to buspiron and the combination with lorazepam might promote its occurrence.

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.

The central venous access device (CVAD) is widely used in infusion of intravenous high nutrient solution, chemotherapy drugs, rapid infusion, blood transfusion, etc. CVAD is left in the patient′s blood vessels for a long time, although it has certain advantages in intravenous therapy, but also risks associated with it. In the past 20 years, many studies have focused on the mechanism of CVAD on vascular injury, trying to explore its mechanism from a different perspective at the microscopic level of pathophysiology. This article will review the three aspects of acute damage to the blood vessel caused by CVAD catheterization and chronic changes caused by indwelling catheters, analysis of the causes of vascular injury caused by CVAD catheterization, and research on preventing vascular injury caused by CVAD catheterization, aiming at providing reference for clinical intravenous therapy.

Objective:To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province.Methods:A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data.Results:The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] ( t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] ( H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively ( Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively( Z=6.722, P<0.05). Conclusions:The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.

Objective: To investigate the bacterial species, characteristics and differences of oral bacteria flora of saliva in the longevous elderly between in Bama county and in Debao county in Guangxi, in order to explore the relationship between longevity and oral salivary bacteria flora in the elderly. Methods: The saliva was taken from the longevous elderly in Bama county(BM group)and people aged over 60 years in Debao county(BS group)separately, and the total DNA was extracted.The 16S rDNA-V4 region was amplified by PCR and analyzed by sequencing.The main species and diversity of bacterial colonies were recorded for difference analysis. Results: A total of 14 saliva samples were collected from 7 cases in BM group and 7 cases in BS group.A total of 369 OTUs were generated by cluster analysis of 14 samples.At the genus level, the dominant salivary bacteria flora were Ctinomyces, Capnocytophaga, Chryseobacterium, Fusobacterium, Haemophilus, Lactobacillus, Leptotrichia, Neisseria, Porphyromonas, Prevotella, Rothia, Streptococcus, Veillonella in both BM group and BS group.The OTU PCA analysis showed that some evidence for indeterminate differences was found, but statistically significant differences did not exist in the dominant components of oral flora between the two groups(P>0.05). Also, the same tendency toward the diversity(P>0.05)was presented.Similarly, the species annotation analysis and the heat map showed that there were no significant differences(P>0.05)in oral salivary flora composition between the two groups.Lactobacillu was always the prevailing flora in the Phylume, Class, Order, Family and Genus, but the abundance ratio was different between the two groups as following: Lactobacillus abundance in salivary bacteria flora was higher in BM Group than in the BS group, while Mycoplasma abundance was lower in BM Group than in the BS group(P<0.05). Conclusions The dominant salivary bacteria flora is Lactobacillus in both BM and BS group, while, the abundance of Lactobacillus is higher in the BM group than in the BS group, which indicates that the longevity of population in Bama county may be related to Lactobacillus.

Objective To discuss the clinical application of cluster nursing in bladder function recovery of cervical cancer patients with radiotherapy.Methods Ninety-four patients with cervical cancer receiving radiotherapy in our hospital from September 2016 to August 2017 were selected as observation group,and 70 patients from January to August 2016 were included in the control group.The control group treated by routine nursing care,while the observation group received cluster nursing.The incidence rate of urinary retention,the success rate of one-time extubation,bladder function recovery and pelvic floor muscle strength before discharge,and quality of life scores before and after radiotherapy were compared between the two groups.Results The incidence of urinary retention in the observation group was lower than that of the control group (4.3％ vs.14.3％,P ＜0.05).The success rate of one-time extubation was higher than that in the control group (94.7％ vs.85.7％,P ＜0.05).The bladder recovery rate was higher than that in the control group (94.7％ vs.83.4％,P ＜ 0.05).The pelvic floor muscle strength was obviously superior than that in the control group (P ＜ 0.05).Quality of life (QOL) score of two groups after treatment were higher than treatment before (P ＜ 0.05),and the observation group was higher than that in the control group (P ＜0.05).Conclusion Cluster nursing can effectively prevent the occurrence of postoperative urinary retention,improve bladder function recovery,and improve quality of life in patients with cervical cancer receiving radiotherapy,so it is worthy of clinical promotion.

Objective To discuss the clinical application of cluster nursing in bladder function recovery of cervical cancer patients with radiotherapy.Methods Ninety-four patients with cervical cancer receiving radiotherapy in our hospital from September 2016 to August 2017 were selected as observation group,and 70 patients from January to August 2016 were included in the control group.The control group treated by routine nursing care,while the observation group received cluster nursing.The incidence rate of urinary retention,the success rate of one-time extubation,bladder function recovery and pelvic floor muscle strength before discharge,and quality of life scores before and after radiotherapy were compared between the two groups.Results The incidence of urinary retention in the observation group was lower than that of the control group (4.3％ vs.14.3％,P ＜0.05).The success rate of one-time extubation was higher than that in the control group (94.7％ vs.85.7％,P ＜0.05).The bladder recovery rate was higher than that in the control group (94.7％ vs.83.4％,P ＜ 0.05).The pelvic floor muscle strength was obviously superior than that in the control group (P ＜ 0.05).Quality of life (QOL) score of two groups after treatment were higher than treatment before (P ＜ 0.05),and the observation group was higher than that in the control group (P ＜0.05).Conclusion Cluster nursing can effectively prevent the occurrence of postoperative urinary retention,improve bladder function recovery,and improve quality of life in patients with cervical cancer receiving radiotherapy,so it is worthy of clinical promotion.