Objective:To investigate the factors related to hypothyroidism induced by programmed death(PD)-1 treatment in elderly patients with cancer.Methods:A total of 193 older patients(≥60 years old)with advanced solid tumors who received PD-1 treatment between January 2018 and January 2021 at the Department of Oncology of Xiangyang Central Hospital were included in this study.The patients were divided into two groups based on whether they were diagnosed with hypothyroidism after PD-1 treatment: the hypothyroidism group(36 cases)and the non-hypothyroidism group(157 cases).The clinical data of both groups, including age, gender, Eastern Cooperative Oncology Group performance status(ECOG PS), PD-1 inhibitors, thyroid function, and thyroid antibody, were compared to analyze the risk factors associated with hypothyroidism.Results:Among the 193 patients, 36(18.7%)were diagnosed with hypothyroidism.The study found no significant differences between the two groups in terms of age, gender, ECOG PS, tumor type, and PD-1 type(all P>0.05).However, significant differences were observed in the baseline levels of thyroid stimulating hormone(TSH)and thyroid antibody subgroups(both P<0.05).The results of multivariate Logistic regression analysis revealed that the presence of baseline anti-thyroid peroxidase antibody(TPOAb)( OR=20.256, 95% CI: 5.709-71.868, P<0.001), the presence of both baseline thyroglobulin antibody(TGAb)and TPOAb( OR=5.853, 95% CI: 1.475-23.227, P=0.012), and an increase in baseline TSH levels( OR=3.065, 95% CI: 1.049-8.959, P=0.041)were identified as risk factors for hypothyroidism induced by PD-1 treatment.On the other hand, there was no significant association between the presence of baseline TGAb and the occurrence of hypothyroidism( OR=1.373, 95% CI: 0.353-5.341, P=0.648). Conclusions:The incidence rate of hypothyroidism induced by PD-1 inhibitors is high among elderly patients with cancer.Additionally, the risk of hypothyroidism is higher in patients with elevated baseline TSH and positive TPOAb.Therefore, it is crucial to remain vigilant for the occurrence of hypothyroidism during PD-1 treatment.Timely diagnosis and treatment of hypothyroidism are necessary to minimize the incidence of adverse events.

Objective: To investigate the current situation and related factors of facial trauma in school age children in urban areas of Fuyang, and to provide basis for child facial trauma prevention. Methods: By cluster stratified random sampling method, a questionnaire survey was conducted among parents of school age children aged 3-6 in four kindergartens in Fuyang City. A total of 1 062 valid questionnaires were included. Results: A total of 146 (13.7%) children with facial trauma were included. The ratio of boys to girls was 1.84∶1.In primary and secondary classes in kindergarten, the reporting rate of boys (24.5%,16.4%) was higher than that of girls (13.4%, 9.0%), and the difference was statistically significant ( χ 2=6.66, 4.25, P <0.05).The incidence of facial trauma was highest (19.4%) in junior kindergarten class children, which decreased with age. Falls injury(61.6%) was the leading cause of facial trauma. Most of facial trauma occurred in family (55.5%) and kindergarten (26.0%). Forehead (26.0%) and mandible (21.2%) were the main injured body sites. Skin laceration (81.5%) was the main type of injury. Facial trauma mostly occurred at 11:00-13:00(19.9%) and 17:00-19:00(27.4%), during June to August (39.7%). The results of univariate analysis showed that the facial trauma of preschool children was associated with gender, class, parentrated child temperament, parental education and family type( χ 2=14.51,18.84,39.66,6.56,12.31, P <0.05). Conclusion Facial trauma in preschool children in Fuyang is common, which varies in gender, class, temperament and family type.

Objective To study mechanical properties of the novel micro-movement elastic implant of distal tibiofibular syndesmosis in dorsiflexion position.Methods A combination of simulation and experiment was used. The normal ankle dorsiflexion model, the bone nail repaired model and the micro-movement elastic implant repaired model were established by using Mimics and CT data. Besides, ANSYS Workbench was used for finite element analysis. Mechanical experiments on lower limb specimens were conducted on Instron E10000 mechanical test instrument, and five sets of experimental data were measured and analyzed.Results Mechanical properties of the micro-movement elastic implant repaired model were closer to those of the normal ankle dorsiflexion model, but stress of the micro-movement elastic implant repaired mode was greater than that of the bone nail repaired model. The results of two-sample heteroscedasticity t test indicated that there was no significant difference in resistance torque between the micro-movement elastic implant repaired model and the normal ankle dorsiflexion model.Conclusions For dorsiflexion position, repairing mechanical properties of the novel micro-movement elastic implant are much better than those of the bone nail, and there is still room for optimizing the micro-movement elastic implant.

Objective:To obtain the inter-fractional set-up errors of intensity-modulated radiotherapy (IMRT) of cervical cancer by cone-beam CT (CBCT), and to analyze the variations of the set-up errors on the cumulative dose deviation of the target volume.Methods:A total of 48 patients with cervical cancer who underwent IMRT were enrolled in this study, and the set-up errors of 696 CBCTs were obtained. The set-up errors were input into the treatment planning system, and the cumulative set-up error dose was obtained by superposing the set-up errors dose. The deviation percentage was calculated by the deviation formula and the standard planning dose.Results:The set-up errors caused the offset of isocenter distance by 0.58(0.36, 0.80) cm. Different statistical differences were noted between the cumulative set-up error dose and the standard planning dose by WilCoxon test. All the dose deviations in the target volume were reduced, and the differential dose volume histogram (DVH) appeared negatively skewed, and the peak value was declined. The DVH diagram shifted to the left with an inverse S-curve and the slope was increased. The HI deviation of the target volume from small to large were: CTV 1, CTV 2, GTV/CTV, CTV 3, CTV n, CTV all, and GTV nd; The HI deviation of the target volume were increased. Conclusions:The effect of set-up errors in IMRT of cervical cancer upon the cumulative doses of the target volume significantly differs. The cumulative dose of the target volume is reduced, and the uniformity of the target volume dose becomes worse. The uncertainty of the inter-fractional position leads to an increase or decrease in the the fractional doses of the target volume. The biological effect on tumor cells and the tumor recurrence remains to be investigated. In IMRT of cervical cancer, the CBCT position calibration is required before each treatment to ensure the dose accuracy of each structure in the target volume.

Objective To compare the clinical effect of two-person operations of disposable circumcision stitching instrument and one-man operations of disposable circumcision stitching instrument.Methods Clinical data of 340 patients with redundant prepuce or phimosis from March 2015 to August 2017 were randomly divided into control group which patients with two-person operation of disposable circumcision stitching instrument and study group which patients with one-man operation of disposable circumcision stitching instrument were reviewed prospectively.There were 188 patients in the study group,including 22 patients with phimosis and 166 patients with redundant prepuce;Among the 152 patients in the control group,there were 17 cases with phimosis and 135 cases with redundant prepuce.Two groups with operation time,intraoperative blood loss,postoperative skin staple missing,2 hours postoperative pain,postoperative edema,the swelling subsided time,postoperative complications,postoperative patient satisfaction,and so on.Measurement data were represented as (x) ± s,and comparison between groups was analyzed using t test;count data were represented as percentage and comparison between groups was analyzed chi-square.Results All operations were finished successfully for the patients by two-person or one-man of operations of disposable circumcision stitching instrument.In terms of operation,the operation time of the observation group and the control group was (7.76 ±0.45) minutes and (7.86 ±0.91) minutes respectively,and the difference was not statistically significant(P ＞ 0.05).Intraoperative hemorrhage of observation group and control group were (1.77 ± 0.22) ml and (1.72 ± 0.26) ml,and the difference was not statistically significant (P ＞ 0.05).There was no statistically significant difference between the observation group and the control group (P ＞ 0.05) in the postoperative 2 hours pain score and skin staple missing.In the postoperative complications,the deviation rate of the prepuce was 1.11％,significantly lower than the control group 5.92％,and the difference was statistically significant (P ＜ 0.05).There was no statistically significant difference between the observation group and the control group in terms of edema on the third postoperative day,short postoperative anastomosis,patient satisfaction,and postoperative infection.Conclusion The way of one-man operation of disposable circumcision stitching instrumente not only saves labor costs,but also has a good postoperative clinical effect,meanwhile,it has high efficiency and strong operability,and is worthy of promotion for clinical first-line urologists.

Objective: To investigate anemia rate and to analyze related factors in maternal women in Taicang of Jiangsu province. Methods: There were 13 278 pregnant women who had prenatal care and gave birth in 25 hospitals during 2014-2016 in Taicang of Jiangsu Province. We excluded 1 179 women who registered after 12 weeks of gestation, 144 women who did not test hemoglobin during gestation, and 25 women whose gestational weeks were incorrect. Finally, data from 11 930 pregnant women were analyzed. From the electronical medical record system of maternal and child health care, we obtained basic information of these pregnant women, their hemoglobin levels and related data during gestation and postpartum. Anemia rate was descripted, and factors associated with anemia were identified using multiple unconditional logistic regression. Results: Age of the 11 930 pregnant women was (27.0±4.5) years old, and the P₅₀ (P₂₅-P₇₅) of BMI at the first trimester was 21.4 (19.6-23.7) kg/m². The anemia rate during gestation was 37.2% (4 434/11 930). The anemia rate was 5.5% (276/5 035), 24.4% (1 802/7 377), and 47.8% (3 328/6 966) at the first, second and third trimesters, respectively. Anemia rate at 42 days postpartum was 19.9% (680/3 418). Multiple unconditional logistic regression indicated that anemia during gestation was related with maternal age <21 years old at prenatal registration (OR (95%CI): 1.28 (1.07-1.53)), body mass index(BMI) <18.5 kg/m² at the first trimester (OR (95%CI): 1.14 (1.00-1.29)), non-local residence (OR (95%CI): 1.35 (1.20-1.52)), education of middle school and lower (OR (95%CI): middle school: 1.24 (1.05-1.47), primary school: 1.36 (1.01-1.82)), occupation of housewife or farmer (OR (95%CI): housewife: 1.21 (1.06-1.38), farmer: 1.21 (1.03-1.44)). Anemia at 42 days postpartum was associated with multipara (OR(95%CI): 1.59 (1.12-2.27)), anemia at the first trimester (OR(95%CI): 3.26 (1.92-5.55)), no folic acid supplementation at the first trimester (OR(95%CI): 1.34 (1.00-1.80)), and hemorrhage≥500 ml during 24 h postpartum (OR(95%CI): 2.26 (1.02-4.97)). Conclusion Anemia rate was low for maternal women in Taicang of Jiangsu Province. The factors associated with gestational anemia included pregnant women's age, BMI, local or non-local residence, occupation, and education. The factors associated with postpartum anemia included multipara, anemia at the first trimester, no folic acid supplementation at the first trimester, and hemorrhage 24 h postpartum.

Objective To investigate the value of multi-b value DWI combined with PSA evaluation on the effect of endocrinotherapy for prostate cancer (PCa), and to study the correlation between the signal intensity(SI), apparent diffusion coefficient(ADC) with PSA.Methods Forty patients with PCa diagnosed by pathology or biopsy were tested for serum PSA levels before and after endocrine therapy.All patients underwent DWI at b-value of 300,800 and 1 000 s/mm2 by using a GE Signa HDx 3.0T MRI scanner.The serum PSA,the value of SI and ADC at different b values before and after endocrine therapy,and their correlation with PSA were observed and measured, respectively.Results (1)The serum PSA before and after endocrine therapy were (35.63±20.91) ng/mL and (5.98±3.84) ng/mL, respectively.The difference was statistically significant (P<0.05).(2)On the condition of different b values, ADC values were (1.06±0.06)×10-3 mm2/s, (0.83±0.04)×10-3 mm2/s, (0.73±0.03)×10-3 mm2/s, respectively before endocrine therapy, and (1.33±0.09)×10-3 mm2/s, (1.16±0.09)×10-3 mm2/s, (1.10±0.08)×10-3 mm2/s, respectively after endocrine therapy.There were significant difference between the ADC values before endocrine therapy and those after endocrine therapy (P<0.05).SI were 809.09±79.06, 417.42±26.65 and 327.42±25.26 in 40 patients with Pca before the endocrine therapy, and 780.10±78.52,409.33±33.93 and 320.00±31.10 after endocrine therapy.The difference was not statistically significant (P>0.05).(3)Pearsoncorrelation analysis showed that ADC value was negatively correlated with serum PSA (r300=-0.58,P<0.01;r800=-0.60,P<0.01;r1 000=-0.66,P<0.01) before endocrine therapy.ADC value was also negatively correlated with serum PSA (r300=-0.55,P<0.01;r800=-0.52,P<0.01;r1 000=-0.61,P<0.01) after endocrine therapy.In addition,SI was negatively correlated with serum PSA (r300=-0.09,P<0.01;r800=-0.18,P<0.01;r1 000=-0.28,P<0.01) before the treatment, as well.Conclusion ADC value at different b values increased after endocrine therapy in Pca, and is negatively correlated with serum PSA.The correlation is the most significant at b value of 1 000 s/mm2.The combination of DWI and serum PSA could be used to monitor and evaluate the effect of endocrinotherapy for Pca, and better guide the clinical treatment of Pca.

Objective To investigate the usefulness of different-b-value diffusion weighted imaging (DWI) in patients with early cerebral infarction and obtain the optimal b value of early cerebral infarction.Methods DWI at b-value of 1,000,2,000,and 3,000 s/mm2 was performed for 40 patients within 72 h after the onset of stroke using a GE Signa HDx 3.0T MRI scanner.Post-processing was done by the DWI specific software Function Tool to gain signal intensity and mean apparent diffusion coefficient in the lesions center and the contralateral normal brain tissue,respectively.The sensitivity of conventional MRI and different-b-value DWI was calculated in the diagnosis of early cerebral infarction.Results In 40 patients with early cerebral infarction,the sensitivity of b-values of 1,000,2,000,and 3,000 s/mm2 (DWIb=1 000,DWIb=2 000,DWIb=3 000) and conventional MRI in the diagnosis of early cerebral infarction were 100％,97.5％,97.5％,72.5％,respectively.With b value increased,signal intensity and ADC value declined.Under the condition of different b values,signal intensity and ADC value were statistically significant in region of interest (P＜0.05).Conclusion DWI is superior to conventional MRI scan in monitoring early cerebral infarction.With the increase of b value,the sensitivity is the higher to hyperacute cerebral infarction,the signal contrast is obvious,while signal to noise ratio of the image reduces.It is suggested that brain tissue contrast and the sensitivity to the new cerebral infarction is more predictable on b value =1,000 DWI than on the other DWIs.

ObjectiveTo study the anti-inflammatory effect of traditional Chinese medicine (TCM) Changweishu on sepsis patients with gastrointestinal dysfunction and its protective effect on intestinal mechanical barrier.Methods A prospective research method was conducted. Fifty sepsis patients with gastrointestinal dysfunction admitted into Department of Emergency Intensive Care Unit (EICU) of Hebei Provincial TCM Hospital from October 2013 to June 2015 were enrolled, and they were divided into a conventional treatment of western medicine control group and a TCM Changweishu group according to the random number table method, 25 cases in each group. The conventional western medicine treatment was given to both groups, and in TCM Changweishu group, additionally Changweishu 1 dose per day, a mixture of following ingredients constituting one dose without decoction, was applied, including: rhubarb 9 g, dandelion 20 g, green tangerine peel 15 g, angelica sinensis radix 15 g, red and white peony each 12 g, rhizome ligusticum 9 g, agrimony 20 g, coptidis rhizoma 6 g, rhizoma pinelliae 6 g, fructus trichosanthis 15 g, garden burnet root 20 g, poria 20 g, and taken once 1/2 dose in the morning and once 1/2 dose in the evening by oral or nasal feeding. After treatment for 7 days, the level changes of inflammatory factors of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), high mobility group protein B1 (HMGB1) and gastrointestinal dysfunction indexes of diamine oxidase (DAO), D-lactic acid in the two groups were observed.Results After treatment, the levels of TNF-α, IL-6, HMGB-1, DAO, D-lactic acid in the two groups were significantly lower than those before treatment [the western medicine control group: TNF-α (A value) 10.89±1.65 vs. 50.30± 1.58, IL-6 (A value) 7.35±1.85 vs. 12.66 ± 1.43, HMGB1 (A value) 5.28 ±1.64 vs. 6.23±0.95, DAO (A value) 5.87±0.59 vs. 6.67±0.49, D-lactic acid (A value) was 2.63±0.17 vs. 4.58±0.16; TCM changweishu group: TNF -α (A value) 5.38±1.19 vs. 51.23±2.34, IL-6 (A value) 5.54±1.26 vs. 13.24±1.78, HMGB1 (A value) 3.69±1.09 vs. 6.14±1.42, DAO (A value) was 3.39± 0.40 vs. 6.70±0.34, D-lactic acid (A value) 1.95±0.13 vs. 4.63±0.11, allP < 0.05]. After treatment, the degrees of decline in indexes of TCM Changweishu group were more obvious than those in western medicine control group [TNF-α(A value) 5.38±1.19 vs. 10.89±1.65, IL-6 (A value) 5.54±1.26 vs. 7.35±1.85, HMGB1 (A value) 3.69 ±1.09 vs.5.28±1.64, DAO (A value) 3.93±0.40 vs. 5.87±0.59, D-lactic acid (A value) 1.95±0.13 vs. 2.63±0.17, allP <0.05].Conclusions TCM Changweishu has protective effect on sepsis patients with gastrointestinal dysfunction, and its mechanisms are the amelioration of damage in intestinal tract mechanical barrier, decrease of permeability of intestinal mucosa and inhibition of levels of inflammatory factors.

[ ABSTRACT] AIM:To investigate the role of ATP-sensitive potassium ( KATP ) channels in the inhibitory effect of hydrogen sulfide ( H2 S) on high glucose ( HG)-induced inflammation mediated by necroptosis in H 9c2 cardiac cells. METHODS:The expression levels of receptor-interacting protein 3 ( RIP3; an indicator of necroptosis ) and cyclooxyge-nase-2 (COX-2) were determined by Western blot.The levels of interleukin-1β(IL-1β) and tumor necrosis factor-α( TNF-α) were detected by ELISA .RESULTS:After H9c2 cardiac cells were treated with 35 mmol/L glucose ( HG) for 24 h, the expression of RIP3 was significantly increased .Pre-treatment of the cells with 100 μmol/L diazoxide ( DZ; a KATP channel opener) or 400 μmol/L NaHS (a donor of H2S) for 30 min considerably blocked the up-regulation of RIP3 induced by HG.Moreover, pre-treatment of the cells with 100 μmol/L 5-hydroxydecanoic acid (5-HD; a KATP channel
blocker) attenuated the inhibitory effect of NaHS on HG-induced up-regulation of RIP3.On the other hand, co-treatment of the cells with 100μmol/L necrostatin-1 ( a specific inhibitor of necroptosis ) or pre-treatment of the cells with 100 μmol/L DZ or 400 μmol/L NaHS attenuated HG-induced inflammatory responses , evidenced by decreases in the expression of COX-2 and secretion levels of IL-1βand TNF-α.However , pre-treatment of the cells with 100 μmol/L 5-HD significantly attenuated the above anti-inflammatory effects of NaHS.CONCLUSION:KATP channels play an important role in the inhib-itory effect of H2 S on HG-induced inflammation mediated by necroptosis in H 9c2 cardiac cells.